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HAWAIIAN ISLANDS. 



Discovered by John Gaetano, Spanish navigator, about the year 1555, on 
one of his voyages between Acapulco and Manila. 

Named by him the "Mesa Islands." Their exact position was hidden from 
other European nations by the Spaniards, for 223 years. 

On January 18, 1778, Captain James Cook, R. N., re-discovered the 
Islands. The islands of Niihau and Kauai were the first lands seen. 

The Hawaiian Islands extend through four degrees of latitude, 18° 30' N 
to 22° 30'N; and six degrees of longitude, 154° 30' W to 160° 30' W. 

The total area of all the islands, large and small, is some 6,454 square 
miles; and they possess a climate "Second to None" in the universe for 
healthfulness. 



^^^fpl'lllllfjlplllllllill 




"THE PATH 
OF THE DESTROYER" 

A HISTORY OF LEPROSY IN THE 
HAWAIIAN ISLANDS 

AND 

THIRTY YEARS RESEARCH INTO THE MEANS BY 
WHICH IT HAS BEEN SPREAD 



BY 

ATA St. M. MOURITZ 

Formerly Physician to the Leper Settlement, 
Molokai. 



Four Maps and Sixty-Nine Illustrations, 
Colored and Plain. 



HONOLULU. 

1916 




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COPYRIGHTED. 

Entered According to Act of Congress, in the year 1916 

by 

A. MOURITZ 

In the Office of the Librarian of Congress. 

All Rights Reserved. 



°fC k2 »9/ 6 



PRINTED IN HAWAII. 

PRESS: HONOLULU STAR-BULLETIN, LTD. 

HONOLULU, MDCCCCXVI. 

LC Control Number 

©GI.A455015 




tmp96 028684 



THIS 

THE FIRST AMERICAN BOOK ON 

HAWAIIAN LEPROSY 

is 

RESPECTFULLY DEDICATED 

TO 

The noble hearted members of the 58th Congress, 
who generously answered the pleadings of the 
Hawaiian people for aid to the afflicted of their 
race, and appropriated the necessary funds to es- 
tablish and maintain a Leprosarium at Kalauwao, 
Molokai. 




£ Ji 



O K/ 

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S- ° 



PROLOGUE. 

The Hawaiians are a very affable, agreeable and lovable peo- 
ple, just as much so as any other on our earth; but in contact with 
disease, all their desirable traits are seriously discounted by their 
lack of care, because they endanger all of us "by failing to obey 
the most simple rules of health, necessary for their own salvation 
and self-preservation." 

It is a most pitiable condition, evident to the most unobserv- 
ing, "that an atmosphere of leprosy clings to and surrounds the 
unfortunate Hawaiian.'' Why? Because he fails to realize the 
danger that menaces him, apart even from the extreme receptivity 
of his system to the bacillus of leprosy, a condition lacking in other 
races domiciled in Hawaii nei : this being an indisputable fact, 
then he (the Hawaiian) is the w r eak link in our chain of national 
health defense. 

It is presumably allowed that the commonhealth is the com- 
monwealth, this being so our duty is plain, we must stand shoulder 
to shoulder with the Hawaiian, brace him up, and support him until 
he can stand alone, like other races ; if he stumbles and falls we 
must raise him, comfort him, sustain him again, like our own 
brother. 

The eradication of leprosy can well begin in the school room, 
like other benign and essential advances; here can be instilled in 
virgin soil, free from the weeds of prejudice, the first principles of 
good health and self-preservation. 

The causes of the decadence of the Hawaiian race are very 
complex ; but the added result indicates that it is due in the main 
to the standard set by modern civilization, which carries in its train 
attendant disadvantages, to wit: New things, strange clothes and 
foods, housing, diseases, medicines, habit-forming drugs, etc., and 
alcoholic beverages. 

The strain is too severe, the Hawaiian falls and drops out ; 
he is not sufficiently fortified ; because of his too brief emergence 
from primitive life. 

Civilization blights aboriginal races, the Hawaiian is no ex- 
ception ; the harsh side of civilization kills by kindness, it may re- 
semble the Greeks bearing gifts, in contact with primitive races 
it is treacherous. 

Apart from its limitedly contagious properties, the disfiguring 
repulsiveness of leprosy alone demands its segregation ; its specific 
contagion, compared to that of Tuberbulosis, is less than one-tenth 
of one per cent. 



PREFACE. 

With the rapidly changing conditions in Hawaii, much valu- 
able material relating to leprosy will soon be lost and buried in 
oblivion. 

Because no one else has written the history of leprosy in 
Hawaii, I have taken up the subject, I admit, with some hesitation 
and misgiving. 

I have also made a special and close study of the cause and 
means by which leprosy has been spread ; the conclusions I have 
arrived at are stated in the pages of this book, but perhaps my 
statement that "Mouth Infection" is the chief means by which 
leprosy has been spread will not be well received ; because the 
song of the siren of inoculation has warbled so long and loudly 
over the land. 

I assume that my views founded on probable evidence of the 
cause of the propagation of leprosy in Hawaii, if accepted, will 
lead the Hawaiian people from the shades of darkness, also other 
races; and that all will be ultimately snatched from the jaws of 
death. 

This Monograph does not cover the entire field of leprosy in 
Hawaii ; historical, ethnical, etiological, and superficial phases of 
pathology, are alone dealt with. 

What work I have done has been carried on in leisure moments, 
which I have been able to snatch from the working hours of a 
busy life; under many difficulties, hindrances, defective apparatus, 
poor quarters, and lack of assistance, skilled and unskilled. Not 
being a Croesus, I could only afford limited time and money. 

My diction and composition are faulty and not free from 
platitudes. I plead that it is better to make a poor attempt than 
none at all, do nothing, assume a somnolent attitude, fold the 
hands until a little sleep comes, etc. ; resulting in valuable material 
on leprosy vanishing forever. 

The language used in this Monograph is mostly non-technical, 
it is intended for the laity and the professional reader. 

Words not in common use are explained in the Glossary. 

THE AUTHOR. 

Honolulu, August 15, 1915. 



I HAVE ACQUIRED MUCH VALUABLE DATA ON THE EARLY 
PREVALENCE AND SPREAD OF LEPROSY IN HAWAII, 
FROM THE FOLLOWING SOURCES: 

ISLAND OF OAHU. 

Alexander, Professor W. D. (Deceased). 

Board of Health Reports. 

Brickwood, Miss Louisa. (Deceased). 

Dayton, David, Esq. (Deceased). 

Emerson, Mrs. Ursula. (Deceased). 

Fathers of the Catholic Mission. 

Fitch, Dr. G. L. (Died June 4, 1904). 

Forbes, Rev. A. O. (Deceased). 

Hoffman, Dr. Edward. (Deceased). 

Judd, Albert F., Esq. (Died May 20, 1900). 

McKibbin, Dr. Robert. (Deceased). 

Parke, W. C, Esq. (Deceased). 

Records of the Hawaiian Board of Missions. 

Trousseau, Dr. George. (Died May 4, 1894). 

Whitney, H. M., Esq. (Died Aug. 17, 1904). 

ISLAND OF MAUI. 

Archambaux, Father Gregoire. (Deceased). 
Burgermann, Father Andre. (Deceased). 
Everett, T. W., Esq. (Deceased). 
Fornander, Abraham, D. C. L., Ph. D. (Deceased). 

ISLAND OF HAWAII. 

Coan, Miss Harriet. (Died July 23, 1906). 

Fathers of the Catholic Mission. 

Kauhane, Rev. J. (Deceased). 

Loots, Father Bonaventure. (Died March 9, 1899). 

Pouzot, Father Charles. (Deceased). 

ISLAND OF KAUAI. 

Rowell, William. E., Esq., C. E. (Died March 18, 1916). 
Wilcox, Luther, Esq. (Died July 3, 1903). 

ISLAND OF MOLOKAI. 

Moellers, Father Wendelin. (Died Sept. 1, 1914). 
Oliver, Dr. Richard. (Died Aug. 12, 1902). 
Swift, Dr. Sydney B. (Deceased). 



/ have made use of the work of the following persons: 

Bertram, Brother, St. Louis College, Map of Molokai. 

Robert, Brother, St. Louis College, Maps. 

Waiamau, John, Artist, seventeen years a resident of Kalaupapa. 

Williams, J. J., and C. Weatherwax, Photos and Views. 



* 



TABLE OF CONTENTS 



PART I. 

Page 

Dedication : ..-. 7 

Prologue — - - 9 

Preface — — 11 

Introduction 21 

Abstract of Contents 24 

Chapter I. Leprosy in Hawaii — 27 

Chapter II. Early History of Leprosy in Hawaii 29 

Chapter III. Climate of Hawaii, and Diseases 36 

Chapter IV. Leprosy in India, Biblical and European 45 

Chapter V. Syphilis, Leprosy, Ethical Phases, Extinction.... 54 

Chapter VI. Segregation : 63 

Chapter VII. The Law of Segregation and its Enforcement.. 69 

Chapter VIII. Excerpts from Board of Health Reports 83 

PART II. 

AGENTS ALLEGED TO SPREAD LEPROSY. 

Chapter I. Vaccination 93 

Chapter I. Mosquito 95 

Chapter I. Flies 98 

Chapter I. Fleas and Bedbugs '... 101 

Chapter I. The Breath of the Leper !.... 103 

Chapter I. Bacilli Leprae External to the Leper... 109 

Chapter I. Carriers of Leprosy Ill 

Chapter I. Awa 115 

Chapter I. Salt Fish 117 

Chapter II. Deductions 124 

Chapter II. Poi vs. Leprosy 125 

Chapter III. Inoculation 138 

Chapter III. Inoculation Experiments by the Author 140 

Chapter III. The Alleged Successful Case of Keanu 152 

Chapter IV. Immunity or Non-receptivity 157 

Chapter IV. Bacterial Infection 158 

Chapter IV. Dr. Hansen's Bacillus Leprae 161 

Chapter V. Contagion 164 

Chapter V. Leprosy Not a Disease of Animals 168 

Chapter VI. More Male than Female Lepers 179 



Page 

Chapter VII. Miscellaneous Topics 186 

Chapter VII. Volatile Oils in Leprosy 186 

Chapter VII. Possible Cause of Different Forms of Leprosy 187 

Chapter VII. Alcohol, in Leprosy 188 

Chapter VIII. Artificial Leprosy 190 

Chapter VIII. Epilogue 193 

Chapter IX. Glossary 194 

Chapter IX. Physicians to Leper Settlement and Leprosarium 198 

Chapter IX. Chronological Table 199 

PART III. 

PERSONAL REMINISCENCES. 

A Responsible Office . . 203 

Autobiography of Mr. Ambrose Hutchison 204 

Fr. Damien, Autobiography of His Work at Kalawao 211 

Fr. Damien, Priest, Leper, Popular Hero 229 

Fr. Albert Montiton . 249 

Fr. Gregoire Archambaux 251 

Fr. Charles Pouzot . 253 

Fr. Andre Burgermann 254 

Fr. Wendelin Moellers, In Memoriam 254 

Thirty-one Years in Office, R. W. Meyer 262 

R. W. Meyer, History of the Leper Settlement 265 

Brother Joseph Dutton . 283 

Franciscan Sister's at Bishop Home 286 

Rev. C. M. Hyde, D.D 288 

PART IV. 

REPORTS ON LEPROSY THIRTY YEARS AGO. 

Republished by Request. 

Report of Queen Kapiolani 295 

Report of Dr. J. H. Stallard 313 

Report of Dr. E. Arning 320 

Letter War re Dr. Arning and Board of Health 341 

Report of Dr. A. Mouritz 357 

Report of Dr. G. L. Fitch 382 

Report of Dr. R. Oliver 398 

PART V. 

Laws Relating to Leprosy 401 



ILLUSTRATIONS 



PART I. 

Page 

Map of the Hawaiian Islands — Frontispiece. 4 

Federal Leprosarium 8 

Relief Map, Island of Molokai 20 

King Kamehameha V 26 

Map of Honolulu _ 31 

Taro Plant 38 

Hawaiian Grass House 42 

Walter M. Gibson 48 

Home of the "Pacific Commercial Advertiser," A.D. 1883 50 

Elderly Hawaiian (w)* 57 

Map of the Leper Settlement 67 

Kalaupapa From the Sea 77 

The Landing at Kalaupapa 81 

Dr. George Trousseau 87 

PART II. 

Hawaiian Type (k)* 97 

Hawaiian Type (w)* 105 

Hawaiian Type (k) 114 

The Meal of Poi and Raw Fish 126 

Our Harbinger of Hope (colored). 129a 

Preparing the Poi 130 

Caucasian-Hawaiian (w) 133 

Chinese-Hawaiian (w) 137 

Dr. G. A. Hansen 159 

Convent of St. Anthony 171 

Our Racial Amalgam 176 

Hawaiian Japanese Girl 181 

Chinese-Hawaiian 185 

Caucasian-Hawaiian _ 197 

* (k) kane or male. 

* (w) wahine or female. 

PART III. 

Fr. Damien, Aged 26 Years 212 

Catholic Mission, Puna, Hawaii 224 

Fr. Damien, Aged 34 Years 230 

Hala or Puhala Tree 233 



Page 

Kalauwao, A.D., 1884 - -- - - - 239 

Fr. Damien, A.D., 1887 ---- 245 

The Tomb of Fr. Damien - - 248 

Kalaupapa, Where Fr. Wendelin worked 255 

Fr. Wendelin - - - ----- - 257 

Fr. Wendelin and His Class 259 

King Kamehameha IV. — - — - 268 

Queen Emma - - 271 

Lieut. Ira B. Dutton, A.D. 1863 284 

Lieut. Ira B. Dutton, A.D. 1877 284 

Brother Joseph Dutton, A.D. 1907 284 

Rev. C. M. Hyde, D.D - 287 

Fort Street Church, A.D. 1884 290 

PART IV. 

Queen Kapiolani 299 

Kalauwao Hospital, A.D. 1884 303 

Queen Liliuokalani 309 

Charles R. Bishop 328 

Bernice Pauahi Bishop 337 

Haleakala, Residence 345 

Henry P. Baldwin 350 

Baldwin Home, Kalawao 356 

The Bethel Street Church, A.D. 1883 361 

Rev. Francis W. Damon 366 

Chinese Mother and Babe 371 

Genuine China 377 

Genuine China 381 

Chinese-Hawaiian 385 

King Lunalilo 390 

The Lunalilo Home 394 

Nodular Leprosy, Mild 

Nodular Leprosy, Medium 

Nodular Leprosy, Severe 

Pigment Deposit in Skin of Breast.... 

Leprous Maculation 

The Leper Ear \ Colored Section 

Dual or Mixed Leprosy 

Dual or Mixed Leprosy 

Neural Leprosy of the Hand 

Neural Leprosy of the Foot 

Neural Leprosy of the Foot 

Leprous Ulcers of the Ileum 



PART I. 




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O oo 

Q ig 

CO 



INTRODUCTION. 

Much has been said and written about "THE BLOT" that 
leprosy is to the Hawaiian Islands; hence the inference is drawn 
"that many TOURISTS and other visitors have hesitated to visit 
Hawaii on account of the prevalence of the disease." 

In order to refute this assumption, I submit the following state- 
ment, and first ask the question: Among what race is leprosy 
endemic? Please carefully read the following figures. 



FIRST AMERICAN CENSUS, A. D. 1900 



Race 


Population 


Lepers 


Ratio 
Approximate 


Race Percentage 

Whole Population 

Approximate 


Hawaiians— . 

Foreigners.—. 


37,635 
116,366 


964 
63 


1 to 39 

1 to 1847 


24% 
76% 


Total 


154,001 


1027 




100% 



In India the ratio of lepers to the healthy is 1 to 1864. The 
above table "shows" in a total foreign population, 76% of the whole 
(composed of a large majority of Asiatics, and a very low propor- 
tion of Caucasians), only 63 lepers exist; whereas, the Hawaiian 
population, only 24% of the whole, produces 964 lepers. 

These figures disclose that the foreign race is practically free 
from the ravages of leprosy; hence the fear of becoming infected in 
Hawaii need not cause alarm to any visitors, or even residents on 
our shores. 

What can carry more conviction than these figures? If they 
do not convey a lesson of comparative non-leprous infection to the 
foreign population domiciled here, nothing that I can write will be 
more convincing. 

The reader can also draw T his own conclusions from the follow- 
ing story. During the years 1884-, 85, 86, 87, I resided at the 
Leper Reservation on Molokai, and during those years I entertained 
twenty-seven visitors and tourists. Over forty other applicants were 
turned down and refused permission to enter the Reservation, the 
chief desire of these people being to see the lepers and take photo- 
graphs. 

If the Board of Health once let down the bars of entrance, 
they would be pestered by many applicants for admission. 

When the sanitary committee of our Legislature announce they 



22 THE PATH OF THE DESTROYER 

propose to visit the Leper Settlement, they are immediately inun- 
dated with requests for steamer transportation to Molokai. 

In recent years, to avoid refusals, and not offend voters and 
others, the date of the steamer's departure is concealed. 

The applications of would-be visitors are not by any means con- 
fined to friends and relatives of the lepers. Strangers, tourists and 
others also apply. 

About the second week of the month of July, 1907, the Pacific 
Commercial Advertiser records on one of its front pages the doings 
of one, Jack London, and his friends at. the Leper Settlement. 

From time to time the mainland papers have printed exag- 
gerated and untruthful stories concerning the status of leprosy in 
Hawaii. It is unnecessary to reply to them; their best refutation 
lies in the eagerness of visitors to gain access to the Leper Settle- 
ment. 

THE DEATH RATE OF ALL THE ISLANDS FOR 
THE YEAR ENDED JUNE 30, 1913, WAS 3,232: OF THIS 
TOTAL, ONLY 48 DEATHS WERE CAUSED BY LEP- 
ROSY, OR OUT OF EVERY 67.33 DEATHS, ONE WAS 
DUE TO LEPROSY. 

THE DEATH RATE FROM LEPROSY PER EACH 
1,000 OF THE POPULATION AMOUNTS TO 0.22. OF 
THE EIGHTEEN PRINCIPAL CAUSES OF DEATH, 
LEPROSY OCCUPIES ONLY THE 14TH PLACE WITH 
48 DEATHS. 

Hawaii has nothing to conceal. A final cold, clinching, de- 
liberate fact is That SEVEN-TENTHS (7/10) per THOU- 
SAND is the extent of the prevalence of LEPROSY amongst all 
FOREIGN RACES domiciled on her shores. 

It is in evidence as a painful and undisputed fact that in 
Hawaii nei, leprosy is a scourge peculiar to the Hawaiian race, and 
its kindred offshoots. 

It is also a singularly significant fact, that with scarcely an 
exception Those FOREIGNERS both MALE AND FEMALE 
who have acquired leprosy are those who have been in particularly 
promiscuous, friendly, and intimate CONTACT with Hawaiians; 
viz., visiting, eating, and sleeping in their homes. 

It is fitting to add — Hawaii declines to receive any lepers 
from Continental United States or elsewhere. Our aboriginal 
racial material is altogether too susceptible and explosive, without 



THE PATH OF THE DESTROYER 23 

any addition of fresh tinder, to possibly kindle into activity the 
supply we have already on hand. 

The Census of the year 1910 gave the number of Hawaiians as, 

Males 13,439 

Females 12,602 



Total 26,041 



Caucasian and Asiatic-Hawaiians are excluded from the above 
figures. 



ABSTRACT OF CONTENTS. 

1. The Bacillus Leprae, discovered by Dr. Gerhard Armauer 
Hansen of Bergen, Norway, in the year 1868, is a plant microscopic 
parasite which finds its most desirable and only habitat in the human 
body, and its presence and development therein produces the three 
forms of leprosy — (a) Nodular or Tubercular, (b) Mixed or Dual, 
(c) Neural or Anaesthetic. 

Dr. Albert L. S. Neisser of Breslau further elaborated and 
added to Hansen's Bacillus the important, features of its being non- 
tnotile, non-flag ellate, and non-sporogenous. 

2. Leprosy is limitedly contagious to the careless contact; 
practically non-contagious to the careful. 

3. Leprosy cannot be conveyed by the breath of a leper, even 
if the contact is close. 

4. Flies, fleas, mosquitoes, and bed-bugs may be ignored as 
active causative factors in spreading leprosy. 

5. The Bacillus Leprae exists outside the body of the leper, 
in graves and toilets, these locations as a means of spreading 
leprosy may also be ignored. 

6. There are carriers of leprosy, who carry the bacillus at 
varying intervals in certain parts of their bodies in the neural 
form, but infection from these foci of the disease cannot be con- 
veyed to contacts. These carriers of leprosy are few in number, and 
as a factor in spreading leprosy they may be safely eliminated. 

7. The main entry of the Bacillus Leprae into the system of 
man is through the mouth and digestive tract, and this is "the path 
of the destroyer." 

8. The mouth and its contained fluid, the saliva, is for all 
practical purposes, the source of contagion to the healthy. 

9. Leprosy as a hereditary affection is of doubtful proof, and 
also hereditary predisposition (so-called) ; nearly all such cases can 
be explained as being post-natal infection. 

10. Leprosy cannot be inoculated upon any dermal surface by 
ordinary means in man (in my experience), but the fetich of inocu- 
lation will not down in this community — it dies hard. 

11. Leprosy is not a disease of animals. They are not recep- 
tive to inoculation on dermal or mucous surfaces. They are appar- 
ently inoculable by intraperitoneal injections of the blood serum 
from dermal blisters or bullae. Feeding leper serum mixed with 
fresh pancreatic juice of the pig, together with previous alkaliniza- 



THE PATH OF THE DESTROY ER 25 

tion of the gastric juice, and administered to certain animals, pro- 
duces a disease resembling human leprosy in some cases as early as 
four months. 

12. The blood per se is not a permanent habitat of the 
Bacillus Leprae. 

13. Vaccination performed aseptically, or even septically, fails 
to fill the bill as a cause of spreading leprosy. 

14. Salt fish, raw fish, poi and awa cannot convey or com- 
municate leprosy unless contaminated by leprous contact. 

15. A "de novo" development of leprosy cannot occur. 



My apology and justification for coming to the front and in- 
flicting the before mentioned statements on the public, is contact 
and practical acquaintance with nearly 4,000 cases of leprosy. 

Thirty years ago, by request of the (then) Board of Health, 
I wrote a report on leprosy, very much against my own will. My 
views at that time were crude, immature, and in the main theo- 
retical, whereas today I am in possession of extensive experience and 
facts. 



INCUBATION 



The incubation of leprosy is the most difficult to fix of any 
known disease; the victim may suspect where, but rarely when he 
he became infected. The necessary work to obtain definite infor- 
mation on this phase of leprosy is enormous; one investigator can- 
not possibly reach reliable results. In the 1,100 cases of con- 
jugal relation mentioned on another page, I could obtain only nine 
wherein it was possible to draw any partially accurate conclusion. 

One. — Length of incubation . 5 months. 

Four. — Length of incubation 8 to 12 months. 

Three. — Lenth of incubation 12 to 15 months. 

One. — Length of incubation 15 to 20 months. 

Minimum length of incubation, average 10 months. 

Maximum length of incubation, average 15f months. 




KING KAMEHAMEHA V. 
Born December 11, 1830. Died December 11, 1872. 
Before ascending the throne known as Prince Lot. He had acted as 
president of the Board of Health before becoming King. On December 28, 
1863, the first official mention of leprosy came up at a Board of Health 
meeting, on the request of the King. 

As King Kamehameha V, he signed and approved the "Act to Prevent 
the Spread of Leprosy," on January 3, 1865. He ascended the throne 
November 30, 1863. 



CHAPTER I. 

LEPROSY IN HAWAII 

No indigenous word for leprosy exists in the Hawaiian language. 

The exact date when leprosy first appeared in the Hawaiian 
Islands cannot be exactly determined ; it is only possible to sur- 
mise when it did, and in the absence of absolute facts, it is the 
only course open. 

There is no word in the Hawaiian vocabulary for leprosy. 
"Mai Pake" or Chinese Sickness, is generally in use to define lep- 
rosy; also "Mai Alii' (the chief's sickness), but it is doubtful if this 
name (Mai Alii) strictly is intended to define leprosy; it more 
properly fills the condition to which we apply the word scrofula. 

It is reasonable to assume that this word "Mai Pake" has 
some connection with the Chinese and leprosy, under two condi- 
tions. Either some Chinaman presented visible evidence of the 
disease to the Hawaiians, or else on interrogation, the Chinese 
stated they were conversant with leprosy and had it in China. 

Chinese visited Hawaii in various ships subsequent to the 
year 1830. The first Chinese coolie emigrants from Hong Kong 
landed at Honolulu January 25, 1852. 

The name "Mai Pake" does not necessarily presuppose that 
the Chinese introduced leprosy into Hawaii, it simply assumes the 
Chinese connection with the word. Abundant and conclusive evi- 
dence, however, exists that the Chinese coolie has carried leprosy 
into other countries. There is scarcely a leper hospital in the 
West Indies and South America that has not had a Chinese leper 
inmate. 

I admit that the mere fact that there is not a distinctive word 
in the Hawaiian language for leprosy argues nothing, but I also 
assert, from many years' contact with the Hawaiian people, that 
when they are in doubt or perplexity about new words, they 
naturally turn to the foreigner for aid — all thinking people will 
admit this. History repeats itself — look back twenty-five years, 
where does the Hawaiian language derive such words as "Mai 
Bubonica,'' year 1899 bubonic plague) ; "Mai Kolera," years 1895, 
1911 (cholera); "Piva Lenalena," year 1911 (yellow fever)? Due 
importance should be attached to this clear evidence. 

Discussing this same question at Kaunakakai, Molokai, in the 
year 1885, with the late Professor W. D. Alexander, a brilliant 
and logical mind, yet withal a most unobtrusive, modest, and silent 
gentleman, I stated my case, on the cause of using the word Mai 



28 THE PATH OF THE DESTROYER 

Pake as outlined above, and asked the Professor what he thought 
of it. He answered: "All you state is probable, tenable, convincing, 
and, short of absolute proof, you make out a strong and plausible 
case." 

Some thirty-five years ago, discussion on the question of the 
origin of leprosy in Hawaii came prominently to the fore. Those 
who maintained that the Chinese origin of Hawaiian leprosy was 
vague and uncertain argued and stated their views as follows: 

"It has been asserted that leprosy was introduced by a China- 
man, and consequently was called Mai Pake, or Chinese Sickness, 
as the Hawaiians had no name for the disease. 

"First. How is it that one Chinaman caused such a spread 
of the disease thirty or forty years ago — 1856 or 1846? 

"Second. If the disease was introduced by the Chinese in 
proportion to their intimate contact and association with Hawaiian 
females (especially young girls), we should expect to find a larger 
proportion of females than males affected with leprosy, and yet 
we all know the contrary is the fact." 

The answer to the first statement is: Nowhere do the up- 
holders of the Chinese connection with leprosy assert, that China 
was the sole origin of the disease in these islands. 

Possibly Hawaii was infected from more than one source. 
Leprosy may have been carried to the islands by the varied and 
mixed peoples which comprised the crews of the numerous whale 
ships, said crews being recruited at ports of the Azores and Cape 
de Verde Islands, East and West Coasts of Africa, Mozambique, 
India, West India Islands, and Malayasia; almost all these coun- 
tries are seats of endemic leprosy. 

The answer to the second allegation, "the intimate and close 
association of the Chinese with young Hawaiian girls as a possible 
cause of spreading leprosy." This statement presupposes and asserts 
that leprosy is conveyed by inoculation, like syphilis, which is an 
absurdity — in fact, leprosy even in the conjugal relation is the least 
likely to be communicated of any disease that can be said to be so 
conveyed, and cannot be compared with syphilis and tuberculosis in 
this respect. 

Nine years after Capt. Cook rediscovered the islands (1778), 
Hawaiians visited China. Chief Keawe Kaiana and three Ha- 
waiians sailed for Canton, China, in August, 1787, with Captain 
Meares in the "Nootka," and remained there three months. 
Kaiana and other Hawaiians visited China again in 1788, in the 
"Iphigenia" and "Felice." 



CHAPTER II. 

EARLIEST KNOWLEDGE OF LEPROSY IN HAWAII 

The best, most capable, reliable, and earliest accounts of dis- 
eases in Hawaii are from the pens of the early American mission- 
aries; the pioneer pilgrims of this mission arrived at Kawaihae, 
island of Hawaii, March 30, 1820, landing from the "Thaddeus." 
Twelve successive companies came to Hawaii over a period of 
twenty-eight years, ending in the year 1848. 

These gentlemen wrote freely and ably, and were keen ob- 
servers of the diseases of the Hawaiians, their food, their morals, 
customs, habits, and methods of living. 

The Rev. Charles Samuel Stewart landed at Honolulu, Oahu, 
April 27, 1823. In Volume I, page 163, will be found the follow- 
ing entry in his record of daily events of date May 22, 1823, 
twenty-five days after his arrival in Honolulu. 

"Not to mention the frequent and hideous marks of a scourge, 
which more clearly than any other, proclaims the curse of a God of 
purity, and which, while it annually consigns hundreds of this 
people to the tomb, converts thousands while living into walking 
sepulchres. The inhabitants generally are subject to many dis- 
orders of the skin; the majority are more or less disfigured by 
eruptions and sores, and many are as unsightly as lepers. The 
number of either sex, or any age, who are free from blemishes of 
this kind is very small, so much so that a smooth and unbroken 
skin is far more uncommon here than the reverse is at home. 

"July 4, 1823. Indeed, we seldom walk out without meet- 
ing many whose appearance of misery and disease is appalling, and 
some so remediless and disgusting that we are compelled to close 
our eyes against a sight that fills us with horror. Cases of opthal- 
mia, scrofula, and elephantiasis are very common." 

The prevalence of disease amongst the Hawaiian people ninety- 
two years ago clearly indicates that the Hawaiian race must then 
have been grievously stricken with many skin and blood maladies, 
and possibly leprosy. 

In the year 1810 the Island of Oahu had sixty foreign resi- 
dents, of many varied nationalities. 

The population of the Hawaiian Islands at the census in the 
year 1823, was 142,050 — all aboriginal Hawaiians. I have pre- 
viously stated the pure Hawaiian population, per United States 
census in the year 1910, was 26,041 souls; these figures show a 



30 THE PATH OF THE DESTROYER 

decrease in the Hawaiian race of 116,009 in eighty-seven years, at 
the rate of about 1,333 per annum. 

Mr. Brickwood, a resident of Honolulu, at one time post- 
master, recognized in the year 1840, the disease of one Ahia as 
leprosy — he was chief in the bodyguard of Kamehameha III. Mr. 
Brickwood had prior knowledge of the disease in Egypt. 

Ahia's case attracted much attention, from the prominent 
office he held, also because he was very popular and much beloved. 
He died in the year 1856; his wife died in the year 1860, she 
was not a leper. 

George Naea, the husband of Queen Emma's mother, was a 
leper in the year 1838; he died in 1854. His wife was not a leper. 

Honolulu, a man residing in Nuuanu Valley, was a leper in 
the year 1839; he died in the year 1860. Mary, his wife, never 
contracted the disease and was living in the year 1884 at Moanalua, 
Oahu. 

In the year 1835 Kamuli, a Hawaiian woman, was living at 
Koloa, Island of Kauai, and there developed leprosy. She died in 
the year 1848, at Waiohinu, Kau, Hawaii. Her husband remained 
free from the disease until the time of his death in 1857; but 
her sister, and two half-brothers had become lepers before the 
year 1838. 

I have selected these few cases of leprosy because their history 
was well authenticated ; the description of them clearly indicates 
that the Nodular form was the disease in evidence (swollen, lumpy 
face, large and pendulous ears, no eyebrows, large, swollen hands 
and feet, and peculiar musty, offensive odour from their persons). 
To my mind, this is clear proof that leprosy prevailed to a moderate 
extent in Hawaii as early as the year 1830; also that some of the 
"remediless and disgusting cases" observed by the Rev. Charles 
Stewart in the year 1823 were quite possibly a double combination 
of diseases, to wit, leprosy and syphilis. 

The history of the foregoing cases of leprosy comes from highly 
reliable sources, viz. : Professor W. D. Alexander, Rev. Sereno 
Bishop, D. D., Luther Wilcox, James Dowsett, Dr. Robert Mc- 
Kibbin, and Miss Louisa Brickwood. All these persons are now 
dead. 

Dr. Hillebrand, an able and accomplished German physician, 
observed Chinese coolies affected with leprosy in Honolulu in the 
year 1848. However, positive evidence free from a shadow of 
doubt is still lacking as to how, when, and from whence? leprosy 
invaded Hawaii. 




MAP OF HONOLULU. 

Kalihi Leper Hospital, left foreground. Kakaako Leper Hospital, right 
foreground. Leper Detention Station, middle foreground. 



32 



THE PATH OF THE DESTROY ER 



About the year 1864 the rapid spread and great increase of 
leprosy began to alarm the community, and steps were taken to 
check the spread of the disease by segregation; and on the 3rd day 
of January, 1865, the law "To prevent the spread of leprosy" was 
enacted by the Legislature of the then Kingdom of Hawaii. 

Honolulu was officially declared a city on August 30, 1850. 
On December 13, 1850, the first Board of Health was organized 
by order of King Kamehameha III, by and with the advice of his 
Privy Council. The members of the board were composed of 
Dr. T. C. B. Rooke, Dr. Geo. A. Lathrop, C. Hoffman, M. D., 
Benjamin F. Hardy, G. W. Hunter, Richard Hill Smith, and W. 
Newcomb — seven members, four to act as a quorum. 

It was not until thirteen years afterwards that the subject of 
leprosy came to be discussed by the Board of Health. In the year 
1863 the report of Dr. Hillebrand, of the Queen's Hospital, for 
the month of April, calls attention to the rapid spread of the new 
disease, called "Mai Pake'' by the Hawaiians. The Doctor terms 
the disease genuine Oriental leprosy. At a meeting of the Board 
of Health held on December 28, 1863, a report of the Mai Pake 
(Chinese disease) came up for the first official discussion. Prince 
Lot, when holding office as Minister of the Interior, presided as 
president of the Board of Health — he afterwards became King 
Kamehameha V. 

At a Board of Health meeting held February 10, 1864, it 
was brought out that leprosy was spreading on the "other islands," 
a census of lepers was ordered and the medical members of the Board 
of Health, Dr. Hoffman and Dr. Hillebrand, were requested to 
go into the question of heredity, contagion, first origin, and similar 
causes. 

At a Board of Health meeting held May 25, 1864, "Mai 
Pake" was again discussed. 

A letter published in the "Pacific Commercial Advertiser," 
May 21, 1864, reports rapid spread of leprosy in Kona, Hawaii, 
and advises that immediate steps be taken to prevent the spread of 
the disease. 

At a Board of Health meeting held August 10, 1864, Dr. 
Hillebrand states that Mai Pake is spreading and recommends 
isolation. 

Kamehameha III died December 15, 1854. No enactment 
against leprosy or any discussion on the subject took place during 
the reign of this king. 



THE PATH OF THE DESTROYER 33 

Kamehameha IV died November 30, 1863; the only official 
mention of leprosy during the reign of this king was, as previously 
stated, by Dr. Hillebrand in a Queen's Hospital report, dated 
April, 1863. 

During the reign of Lot, Kamehameha V, an act to prevent 
the spread of leprosy was enacted, w T hich is here given in full. 

AN ACT TO PREVENT THE SPREAD OF 
LEPROSY, 1865 

Whereas, The disease of leprosy has spread to considerable ex- 
tent among the people, and the spread thereof has excited well- 
grounded alarms, and whereas, further, some doubts have been 
expressed regarding the powers of the Board of Health in the 
premises, notwithstanding the 302d Section of the Civil Code, and 
whereas, in the opinion of the Assembly, the 302d Section is 
properly applicable to the treatment of persons afflicted with leprosy. 
Yet for greater certainty and for the sure protection of the people : 

Be it enacted by the King and the Legislative Assembly of the 
Hawaiian Islands, in the Legislature of the Kingdom assembled : 

Section 1. The Minister of the Interior, as President of the 
Board of Health, is hereby expressly authorized, with the approval 
of the said Board, to reserve and set apart any land or portion of 
land now owned by the Government for a site or sites for an estab- 
lishment or establishments to secure the isolation and seclusion of 
such leprous persons as, in the opinion of the Board of Health or 
its agents, may, by being at large, cause the spread of leprosy. 

Section 2. The Minister of the Interior, as President of the 
Board of Health, and acting with the approval of the said Board 
may acquire for the purpose stated in the preceding section, by 
purchase or exchange, any piece or pieces, parcel or parcels of land, 
which may seem better adapted to the use of lepers than any land 
owned by the Government. 

Section 3. The Board of Health or its agents are authorized 
and empowered to cause to be confined, in some place or places 
for that purpose provided, all leprous patients who shall be deemed 
capable of spreading the disease of leprosy, and it shall be the 
duty of every police or District Justice, when properly applied to 
for that purpose by the Board of Health, or its authorized agents, 
to cause to be arrested and delivered to the Board of Health, or 
its agents, any person alleged to be a leper within the jurisdiction 
of such police or District Justice ; and it shall be the duty of the 



34 1 HE PATH OF THE DESTROYER 

Marshal of the Hawaiian Islands and his deputies, and of police 
officers, to assist in securing the conveyance of any person so arrested 
to such place as the Board of Health, or its agents, may direct, in 
order that such person may be subjected to medical inspection, 
and thereafter to assist in removing such person to a place of treat- 
ment, or isolation, if so required by the agents of the Board of 
Health. 

Section 4. The Board of Health is authorized to make such 
arrangements for the establishment of a hospital where leprous 
patients in the incipient stages may be treated in order to attempt 
a cure, and the said Board and its agents shall have full power 
to discharge all such patients as it shall deem cured, and to send 
to a place of isolation contemplated in Sections 1 and 2 of this 
Act, all such patients as shall be considered incurable, or capable of 
spreading the disease of leprosy. 

Section 5. The Board of Health, or its agents, may require 
from patients such reasonable amount of labor as may be approved 
of by the attending physicians, and may further make (I have never 
known of a single instance where the foregoing regulation re laboi 
to be performed by a leper, was enforced — Author) and publish 
such rules and regulations as by the said Board may be considered 
adapted to ameliorate the condition of lepers, which said rules and 
regulations shall be published and enforced as in the 284th and 
285th Sections of the Civil Code provided. 

Section 6. The property of all persons committed to the care 
oi the Board of Health for the reasons above stated shall be liable 
for the expenses attending their confinement, and the Attorney 
General shall institute suits for the recovery of the same when re- 
quested to do so by the President of the Board of Health. (Never 
enforced — Author. ) 

Section 7. The Board of Health, while keeping an accurate 
and detailed account of all sums of money expended by them out 
of any appropriations which may be made by the Legislature, shall 
keep the amounts of sums expended for leprosy distinct from the. 
general account. And the said Board of Health shall report to 
the Legislature at each of its regular sessions, the said expenditures 
in detail, together with such information regarding the disease of 
leprosy, as well as the public health generally, as it may deem to 
be of interest to the public. 

Approved this 3rd day of January, 1865. 

KAMEHAMEHA V. 



THE PATH OF THE DESTROYER 35 

Section 302 previously referred to is as follows: 

When any person shall be infected with the small-pox or 
other sickness dangerous to the public health, the Board of Health, 
or its agents, may, for the safety of the inhabitants, remove such 
sick or infected person to a separate house, and provide him with 
nurses and other necessaries, which shall be at the charge of the 
person himself, his parents or master, if able; otherwise at the 
charge of the Government. 

Here is legislative enactment relating to leprosy which ante- 
dates a law passed in 1909. The framers of this later law evidently 
overlooked it. 

AN ACT TO AMEND SECTION 4 OF CHAPTER 62 
OF THE PENAL CODE 

Be it enacted by the King and the Legislative Assembly of 
the Hawaiian Islands in the Legislature of the Kingdom assembled: 

Section 1. That Section 4 of Chapter 62 of the Penal Code 
be and the same is hereby amended so as to read as follows: 

Section 4. "The Board of Health is authorized to make 
arrangements for the establishment of hospitals, on each island, 
where leprous patients in the incipient stages may be treated in 
order to attempt a cure; and the said Board and its agents shall 
have full power to discharge all such patients as it shall deem 
cured, and to send to a place of isolation contemplated in Sections 
1 and 2 of this Act, all such patients as shall be considered incur- 
able or capable of spreading the disease of leprosy." 

Section 2. This Act shall become a law from and after the 
date of its passage, and all laws in conflict with the provisions of 
this Act are hereby repealed. 

Approved this 11th day of August, A. D. 1884. 

KALAKAUA REX. 

Other laws relating to the care, treatment, and segregation of 
lepers will be found at the end of this book. 



CHAPTER III. 

CLIMATE OF HAWAII 

From Dr. Alonzo Chapin's description of the Hawaiian cli- 
mate in the year 1836. (He was a Missionary physician.) 

"Situated in the very midst of the vast Pacific, without any 
extensive inland causes to affect the temperature, and remote from 
the cold, chilling winds of the temperate and frigid zones, the 
Sandwich Islands possess a remarkable evenness in the degree of 
atmospheric temperature; cool breezes by day from the sea, by night 
from the mountains, serve to mitigate the burning heat produced 
by a vertical sun, and to render the climate pleasant. The ther- 
mometer varies but little from day to day, and even from month 
to month ; and what is particularly to be remarked, all portions of 
the islands, along the shores, are alike in this respect. Districts 
most parched by heat and drought do not differ essentially in tem- 
perature from those sections where almost daily showers and per- 
petual trade winds prevail. As we recede, however, from the low- 
lands along the sea and ascend the mountains, a change is imme- 
diately perceived, and along their extended sides we may procure 
almost any degree of temperature. 

The greatest heat marked by the Fahrenheit thermometer at 
Honolulu was 85°, lowest, 55°. 

PHYSICAL FEATURES, TELLURIC AGENCIES, ETC. 

The interior of each island is uniformly elevated, and among 
them are found mountains of the first order of elevation. 

Those on Hawaii rise to the height of about 14,000 feet, 
and have snow on their summits a great, part of the year. The 
whole group are of volcanic origin, numerous extinct craters of 
different periods and dimensions are scattered over the surface, and 
two large volcanoes, Maunaloa and Kilauea, are still in action, 
affording immense currents of liquid lava. The shores of the 
islands are much diversified and furrowed with frequent ravines, 
some of great depth, which furnish courses for the impetuous moun- 
tain streams. Plains of different dimensions, varying from a few 
rods to many miles in extent are frequent. More commonly, how- 
ever, the mountains extend with a gradual slope entirely to the 
beach, and here and there present bold and black lofty precipices 
to the dashing of the waves. The sides of the mountains, if we 
except the loftiest, are verdant entirely to their summits, and pre- 



THE PATH OF THE DESTROY ER 37 

sent immense tracts of exceedingly fertile soil. The leeward shores 
have generally an arid and even sterile aspect, owing to the infre- 
quency of rain, and cultivation is there promoted mostly by irri- 
gation from the streams, and it is only the tracts immediately 
contiguous to these which possess much verdure or will admit of 
cultivation. The condensation of the vapor from the moist ocean- 
borne trade winds in their passage over the mountains produces 
continual rains on their summits, which, extending backwards to- 
wards the sea, keeps the earth wet much of the time and gives 
rise to a luxuriant growth of vegetation. Hence the windward 
sides of all the islands are, unlike their leeward shores, extremely 
fruitful and productive. The streams originating from springs and 
rains on the summits of the mountains, pour down their sides with 
great impetuosity, and after a few meanderings are turned aside 
from their course to irrigate the lands and replenish the fish ponds, 
or are discharged directly into the sea; and I know of no body 
of water emitting sufficient miasma to create sickness along its 
borders. 

I have occasionally met with stagnant ponds which emitted a 
foul and offensive odor, and could in no way satisfy myself of the 
reason for the exemption of the inhabitants along their borders 
from fevers, but by supposing the effluvia to be diluted and ren- 
dered inert by the continual currents of winds. (The true reason 
is because no malaria transmitting mosquitoes infest Hawaii — Au- 
thor). Small marshes abound, but are fed by springs and the pure 
mountain streams, and are thus prevented from becoming noxious. 
They speedily dry up during a few weeks' absence of rain, and 
the rivers also disappear unless kept alive by frequent showers and 
the small pools, which remain at such times and which abound 
after every rainy season, do not become sufficiently putrid to exhale 
a fever generating miasma. (We have the day mosquito, the species 
that infects man with yellow fever, but we have NO yellow fever 
in Hawaii. Dengue is probably spread by the night and day 
mosquitoes, but it is a very mild disease in Hawaii, and is not 
endemic. — Author. ) 

If any one variety of soil has a specific power to produce 
malaria, it does not exist in Hawaii. The upland soil is formed 
of decomposed lava, the lowland plains along the sea are constituted 
of a mixture of alluvium washed from the mountains and decom- 
posed coral. Its immunity from noxious exhalations is the same, 
whether parched with drought or merely moist, as when the evapor- 
ation is most abundant after the rains. 




THE TARO PLANT. 



The tops are cooked and eaten like spinach. The root furnishes the 
famous Hawaiian poi. 



THE PATH OF THE DESTROYER 39 

The staple article of diet is poi made from the taro plant, the 
Arum Esculentum, which is more generally eaten by the Hawaiian 
people than any other vegetable ; it grows like the Arum Triphyllum 
in wet or damp situations only, and when uncooked is exceedingly 
styptic and acrimonious — these qualities are destroyed by heat. The 
natives prepare it for use by thorough cooking, pounding it to a pulp, 
and adding sufficient water to make a thick paste, in which state it 
is called poi, and thus prepared, it is eaten with one or two 
fingers, according to its consistency. As an article of diet it is 
simple and nutritious, and after the fermentative process has com- 
menced it is preferred by the people. 

The sweet potato, the pala, a fern root, the tops of pulu fern, 
the nut of the kukui, the banana, many varieties of seaweed, along 
with a great variety of fish and Crustacea, are eaten raw. The meat 
of the pig, dog, fowls, beef, mutton, salt salmon constitute the 
chief articles of Hawaiian diet, most of these are cooked, baked in 
an underground oven. 

The equableness of the climate and the simplicity of the 
Hawaiians in their regimen and most of their habits of life are, 
compared with other civilized countries, such, that the variety of 
their diseases is neither numerous nor complex. Their remoteness 
from other lands is so great that few contagious diseases are 
imported amongst them. The diseases most common are fevers, 
ophthalmia, catarrhs and asthma, rheumatism, diarrhoea, dysentery, 
cutaneous diseases, tuberculosis, dropsy, venereal diseases, and 
they occur in frequency and in about the order I have mentioned 
(this was in the year 1836) ; diseases sometimes occur epidemically, 
as was the case with catarrh, repeatedly, and croup once during 
my residence at the islands. Many other diseases not specified 
were often met with. 

Fevers, though this is the most frequent and numerous class of 
diseases among the native population, they are by no means the 
most malignant and fatal. They occur in almost every form, but 
when idiopathic, are usually remittent. They are, however, most 
frequently symptomatic of other diseases. The excitable state of 
the system, which predisposes so strongly to febrile attacks, is 
not common to these islands, and the universal custom of the people 
to repose during the hottest part of the day aids in counteracting 
other unfavorable influences. 

The simplicity, too, of their diet and habits of life is not 
calculated to promote a state of excitability. 

Their food is mostly vegetable and fish, with but a scanty 



40 THE PATH OF THE DESTROY ER 

and irregular supply of meat; until of late they made no use of 
alcohol, and no stimulating condiments so freely employed in civilized 
countries. Their only drink is water, kokoolau tea, awa they use, 
prepared in a none too cleanly fashion. Cold, which operates more 
extensively than any other morbific agent, produces probably more 
than one-half of all the diseases which exist, and more than three- 
quarters of all the idiopathic fevers on the islands. The habitations 
of the natives are considerably scattered, but in a few instances 
crowded together in such numbers as to exhibit the dense appear- 
ance of large towns and villages. 

There is, however, throughout, an entire exemption from 
those pestiferous exhalations which so extensively poison the at- 
mosphere of populous places in hot climates. All animal and 
vegetable substances thrown away by the people or cast up by the 
sea are quickly devoured by the number of hungry dogs and 
swine, so that no detriment is experienced from their putrefaction. 
The dwellings of the native population are merely slender frames 
of posts and poles tied with strings and covered only with thatch; 
they are generally small, often so low as not to admit of standing 
erect within, and in their best condition serve as an imperfect 
protection from the wind and rain and the excessive heat of a 
vertical sun. Every atmospheric change is quickly felt, cold and 
dampness easily penetrate, and no sooner exist without, than they 
are felt within. Add to this their leaky condition, the almost naked 
state of the inhabitants, their common practice of sleeping at night 
on the bare earth outside of their houses, and their habit of con- 
tinuing long in the water and exposing their bare bodies to the 
strong currents of wind, when overcome with heat and perspir- 
ation, and it will not be surprising that diseases incident to such 
causes should abound. Fevers induced thereby are very prevalent." 

Robert Crichton Wyllie, Prime Minister of the Hawaiian King- 
dom, requested answers from all of the American missionaries in 
the Hawaiian Islands, in May, 1846, "On the Influence of the 
Native Houses on Health." 

Rev. Titus Coan: "Native houses are usually too small, too 
low, too dark, not well ventilated, too filthy, and too perishable in 
their materials and construction." 

Rev. J. Green: "The native houses are certainly defective, 
exceedingly so, most of them are without partitions. Still, nearly 
all could make improvements in their style of building comfortable 
dwellings." 



THE PATH OF THE DESTROYER 41 

Rev. E. W. Clark: "The houses generally are grass huts, 
many of them miserable; some have permanent partitions, but not 
the majority. Less improvements have been made in houses and 
in dress and furniture. Natives accustomed so long to a mere 
shelter do not feel the inconvenience of their houses." 

Rev. R. Armstrong: "The houses are generally too small, 
without ventilation, floors, windows, or partitions, and extremely 
unhealthy. Many are very damp from the ground, as well as 
from the rain.'' 

Rev. B. W. Parker: "The native houses are almost invariably 
small, poor, and uncleanly." 

Rev. A. Bishop: "The houses of the common people are de- 
fective in almost everything w T hich constitutes civilization." 

Rev. J. S. Emerson: "The native grass houses, when built 
well, are probably more healthy than any others, if they are not 
suffered to be damp by having no floor. The convenience of 
windows w T ould be great, but expensive. Floors would greatly 
induce to health, partitions would aid much in advancing moral 
purity, but neither are much sought by the people at present." 

Rev. J. Green: "The method of living in small houses 
having no partitions, and crowded with men, women and children, 
is exceedingly unfavorable to the formation and strengthening of 
the virtuous habits, but exceedingly favorable to the vicious pro- 
pensities." 

CERTAIN AILMENTS UNDERMINING THE 
HEALTH OF HAWAIIANS 

If it be a fact that the aborigines of America were affected 
with syphilis and gonorrhoea before Europeans visited them, it is 
certain neither disease existed or was known in Hawaii before 
the visit of Captain James Cook in January, 1778, and the "Lady 
Washington," from Boston, July, 1785. At or about this time the 
foreigner is credited with having introduced into Hawaii the 
two above diseases, w T hich rapidly spread amongst the native Hawai- 
ians; following the well-known pathological law, "any infective dis- 
ease finding new fields, is always more virulent than the same dis- 
ease prevailing amongst older communities." 
CUTANEOUS DISEASES, SCROFULA AND EPIDEMICS 

Still quoting Dr. Chapin (because the Hawaiian people num- 
bered 108,579 about the time of the Doctor's observations, and 
he had a larger aboriginal field to survey than we have today). 



THE PATH OF THE DESTROY ER 43 

"Though the Hawaifans are remarkably fond of the water 
and are fastidiously particular in their practices of washing and 
bathing, they are, nevertheless, somewhat uncleanly in some respects 
in many of their habits of life. Beasts and fowls occupy the same 
habitation, and not unfrequently on the same mats with themselves; 
their oft-repeated ablutions may be regarded as timely. The kapa, 
or native cloth, is worn without cleansing, till having become 
foul with dirt and vermin, and too ragged to serve longer the 
purpose of covering or protection, it is laid aside. Hence diseases 
induced or exacerbated by such causes have a fruitful soil, and 
flourish luxuriantly. The itch is extremely prevalent, and often 
assumes a virulence unknown in our own country. The pustules, 
becoming confluent, are converted into large and troublesome ul- 
cers; other scabious diseases exist. Scrofula is not only frequent, 
but extremely malignant.'' 

Quotations from other missionary workers are here stated, 
concerning diseases of Hawaiians. 

Mr. Coan: "The principal diseases are of the venereal, scrof- 
ula, and cutaneous character. The climate is very healthy." 

Mr. Green: "No contagious or epidemic diseases prevail at 
Makawao, occasionally influenza prevails; since I have resided 
here few diseases prevail." 

Mr. Bishop: "No contagious diseases except cutaneous erup- 
tions, which are very prevalent and distressing. Most prevailing 
and mortal diseases are due to venereal corruption of the blood." 
Mr. Emerson: "The itch and venereal diseases are destruc- 
tively contagious." 

In answer to another question of Prime Minister Wyllie's 
"How far is the health of the Hawaiian affected by the enervating 
effects of indolence and indifference as to anything beyond the 
mere wants of animal existence?" 

Mr. Coan: "Physical, mental, and moral inbecility, diseases 
and vice, are extensively engendered and sadly perpetuated by indo- 
lence and indifference to anything beyond the mere wants of 
animal existence." 

Mr. Green, greatly affected: "Nothing compared with these 
as a source of suffering, both moral and physical. Here is the 
fruitful source of vice, misery, and death. The nation is rusting 
out." 

Mr. Clark: "Indolence here, as everywhere, has a debasing 
influence on the moral and physical condition of the people. It 



44 THE PATH OF THE DESTROYER 

is the mother of vice and disease. As artificial wants increase, the 
character of the people is generally elevated." 

Mr. Parker: "Both the moral and physical health of the 
natives is most seriously affected (injured) by their indifference 
and improvidence." 

Mr. Bishop: "Indolence is attended with enervating effects 
on the constitution. This is evidenced in females who have noth- 
ing to do, and yet they are more subject to sickness than the men. 
Perhaps there are other causes productive of sickness in many 
females, the consequences of vicious idleness." 

Mr. Emerson : "This people are indolent and many of them 
are improvident, and sickness and death are often the result of 
this improvidence. They have no beds for the sick, and no suit- 
able food or diet in such cases. Their houses, mats and sleeping 
places often generate disease and prevent the effects of suitable 
remedies, if administered, and often deter from the attempt to 
administer remedies that would be suitable, if circumstances would 
allow of their use. But whether this indolence and improvidence 
are peculiarly inherent in the Sandwich Islands, or the result of 
a system of oppression long practiced, in connection with the ab- 
sence of that stimulus produced by artificial and imaginary wants 
connected with civilization, is yet to be proved." 

Mr. Gulick: "Very injurious and to a considerable extent. 
Yet this indifference appears to be merely the result of the system 
by which, till recently, they were deprived of nearly all their 
rights, and thereby precluded from the hope of materially better- 
ing their condition." 

Mr. Johnson: "I think the moral and physical health of this 
people is in some degree injured by indolence and indifference to 
the wants of both body and soul." 



CHAPTER IV. 

LEPROSY IN INDIA 

The secretary of the government of India states that at the 
present day, "there appears to be at least three centers of com- 
paratively intense prevalence amongst the teeming millions of 
people," viz.: 

"(a) The Beerbhoom and Bancoora districts in the lower 
provinces of Bengal; 

"(b) The Kumaun district in the northwestern provinces; 

"(c) The Deccan and Konkan in the Bombay and Madras 
presidencies, respectively.'' 

( ? From these great and ancient races were derived the Ha- 
waiians. — Author. ) 

Indian Report, page 80, Messrs. Lewis and Cunningham, 
assistants to the sanitary commissioner of India, state: "That 
leprosy has been known in India for 3,000 years, but with regard 
to our definite knowledge of its actual causation, it is to be feared 
that we have not, except phraseologically, advanced very much on 
the etiological views recorded by Atreya, many centuries before 
the Christian era, which were to the following effect: 

"When the seven elements of the body become vitiated through 
the irritation of the wind, the bile, and the phlegm, they affect 
the skin, the flesh, and the spittle and the other humours of the 
body. These seven are the causes respectively of the seven varieties 
of Kushta (leprosy), the Kudig of the Javanese." 

This medical philosopher Atreya lived at least 2,000 years 
before the Christian era and wrote the 'Charaka Sanpita' on the 
pathology of the disease, extracts from which are as follows: "The 
man who neglects the disease at its commencement is sure to die, 
for it becomes incurable." 

He described 4,000 years ago the various kinds of leprosy, 
the descriptions of which are so clear that they accurately delineate 
the disease as it is existing today. "The Kushta (leprosy) thus 
produced causes much pain and suffering — none of these varieties 
result, however, from the vitiation of a single humour. 

Kushtas are of seven, or eleven, or a larger number of a kind, 
and these, constantly irritating the system, become incurable. 

The wind, the bile, and the phlegm, being vitiated, react 
on the skin. When the wind is most vitiated, ' it produces the 
Kadala Kushta. 



46 THE PATH OF THE DESTROYER 

When the bile is the most vitiated, the Audumbara. 

When the phlegm is the most vitiated, the Mandala. 

When the wind and the bile are affected, the Rishyajihva 
occurs. When the three, the bile, the phlegm, and the wind, the 
Sidhma is produced, and the three together produce the Ka- 
kanaka." 

The causes of the disease Atreya states to be as follows: 

1. Excessive physical exercises after exposure to too much 
heat or too much cold. 

2. Taking food after surfeit. 

3. Eating of fish with milk. 

4. Using barley with several other grains, such as "Hayanaka," 
"Dalaka," "Karsdusa," along with venison, milk, curdled milk and 
butter milk. 

5. Excessive sexual intercourse. 

6. Long protracted excessive fear or labor. 

7. Fatigue, interruption of catarrh, vitiate the phlegm, the 
bile, and the wind ; hence the skin and the three others become 
slackened. Thus irritated the elements corrupt the skin, and 
other humours and produce Kushta (leprosy). 

The premonitory symptoms of Kushta are as follows: ''Want 
or excess of perspiration, roughness, discoloration, itching and in- 
sensibility of the skin, pain, horripilation, eruption, and excessive 
pain in the parts that are about to fall off. 

The worms that form in leprous eruptions destroy the flesh, 
skin, veins, muscles, and bones and when affected by these worms, 
the patient suffers from spontaneous discharges of blood, insensi- 
bility, loss of sensibility of the skin, mortification, thirst, fever, dys- 
entery, burning weakness, disrelish, and indigestion. The Kushta 
then becomes incurable." 

LEPROSY OF THE BIBLE 

The Biblical leprosy may have been derived from this same 
source, "the cradle of the world.'' 

Atreya was the first writer on leprosy, followed several cen- 
turies later by Moses, as set forth in the Book of Leviticus, and 
it is reasonable to assume that the people of Israel carried the dis- 
ease into Egypt; hence the warning in Deuteronomy, Chapter 28, 
verse 27 : "The Lord will smite thee with the Botch of Egypt, 
and with the Emerods, and with the Scab, and with the Itch 
Whereof thou canst not be healed/' These must have been 



THE PATH OF THE DESTROYER 47 

some dreaded and incurable diseases. While the Greek word 
"Lepra" means scaly, or skin disease, instances where true leprosy 
was the disease, and that it was contagious in those times is evi- 
denced in the casting out of the lepers, their clothes and homes 
being destroyed. 

That the leprosy of the Bible was evidently regarded as con- 
tagious, that skin manifestations were in evidence, and that it was 
also incurable, may be inferred, and is set forth in the appeal of 
the ten lepers to "the Master Physician, Christ," for aid. "We 
are incurable, aid us." "We stand afar off, contagious." And one, 
when he looked at his clean skin (where the disease had been) and 
saw the changed condition, gave thanks to God ; hence his skin 
must have been one of the main situations of his leprosy. 

THE LATE PRIME MINISTER W. M. GIBSON'S VIEWS 

The late Walter M. Gibson, Prime Minister in King Kala- 
kaua's reign, and also president of the Board of Health, a bright, 
clever, incisive writer and speaker, brings forward the theory, 
"That, inasmuch as the Polynesian race (the Hawaiians are a part), 
had their origin in India and gradually moved away from that 
cradle of all mankind, where leprosy has been known to exist for 
3,500 years, it is within the bounds of probability that, they carried 
the seeds of leprosy with them," and when syphilis was brought to 
Hawaii by the crews of Captain James Cook's ships, it fanned 
the latent leper taint into activity, and this accounts for the prev- 
alence of leprosy in Hawaii today. 

Mr. Gibson was an able and convincing writer, and elabor- 
ates and freshens up his theory with very plausible statements, 
anyone can read them in full in the Board of Health reports of 
previous years. But alas! all that fine writing and elaborate argu- 
ment is lost on the Author (one of the self-assertive doctors, as he 
is pleased to call any of us who have the courage to express and 
maintain our own opinions). 

The bacilli of leprosy and syphilis, instead of attacking each 
other, sleep together like firm friends, and 3,500 years of leprosy 
passing through the bodies of the Hawaiian people should have 
rendered and given them some immunity. The Gibson theory 
works the wrong way, and is in conflict with the laws and doc- 
trines of our most able pathologists and bacteriologists. 

I present some more of Mr. Gibson's statements: "Leprosy 
has attacked at times every race in the world, but its chief abid- 



h 





WALTER MURRAY GIBSON. 

King Kalakaua's Kuhina Nui or Prime Minister, 1882-7. President of 
Board of Health, managing editor of "Advertiser" and the Hawaiian ver- 
nacular newspaper, "Nuhou." 

Orator, diplomat, writer, able, shrewd; resisted and easily out-ma- 
noeuvred the efforts of his opponents to remove him from office. He was 
OUSTED from office by the Revolution in Honolulu, June 30, 1887. The 
political battles in the years 1884-86 in the Hawaiian Legislature had some 
semblance to the British troubles in the time of Charles I, only King 
Kalakaua and two-thirds of his parliament opposed a one-third minority. 
Cromwell, Ireton, Bradshaw, Fairfax, and Hampden, had similar repre- 
sentation in the Hawaiian Legislature. Mr. Gibson died in exile in San 
Francisco, California, January 21, 1888; his body was brought to Hono- 
lulu for burial. 



THE PATH OF THE DESTROY ER 49 

ing places have been beds of the fell disease — in Java and other isl- 
ands of the great archipelago, where the natives present most 
striking affinities with the Hawaiian race; the diseases that affect 
them also afflict the Hawaiians. 

The Javans treat as outcasts all who are suffering with the 
Kudig, or leprosy, and the unfortunate ones have voluntarily segre- 
gated themselves upon small islands, where they are supplied with 
means of subsistence by their friends." 

CENSURE OF THE DOCTORS 

The late Walter M. Gibson, when president of the Board 
of Health in the year 1886, seemed to express surprise that the 
medical profession should be so divided on the question of: (First) 
"Contagiousness of Leprosy;'' (Second) "The absence of an una- 
nimity of opinion on the cause of the spread of the disease in 
Hawaii," and (Third) "Failure to check or cure it." 

Mr. Gibson was one of the brainy men of that by-gone age, 
the days of the monarchy; he was a fluent, able, and interesting 
speaker. I set forth one of his caustic declamations against the 
medical profession in Hawaii. 

"The sooner medical men get down to some sensible base 
and conclusions on leprosy, the better it will be for all mankind. 
The average thinking layman in Hawaii Nei can draw con- 
clusions on the subject of leprosy as good, if not better, than many 
members of the medical profession. The layman is not wedded 
t@ any pet theory, does not try to look wise when he talks on 
this subject of leprosy. Is it not a fact that doctors pretend to 
know a great deal more than they do know? 

Their so-called dogmas, theories, and nescience change with 
the wind, their views are bewildering, prone alas! at times to be 
blindly self-assertive, dogmatic, and tyrannical; pledged to indi- 
vidual schools of thought, and sometimes their attitude to each 
others' theories and arguments assumes the fierce form of dog- 
eat-dog! This may be overdrawn, but if you reflect, gentlemen, 
you must admit its truth. 

In order to cure the Hawaiian race of its ills it requires the 
spirit of divine love, not the stern, scientific methods of London, 
Berlin, Paris, New York or elsewhere." 






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THE PATH OF THE DESTROYER 51 

EUROPEAN LEPROSY 

A world-wide prevailing disease like leprosy would be ex- 
pected to respect no country. We are told by historians that the 
Crusaders acquired the disease in Asia Minor and Palestine about 
the year 1100, A. D., brought it back with them and thereafter 
it spread all over Europe. 

It has been estimated that the continent of Europe in the 
middle ages had an approximate population of 50,000,000 people, 
and 10,000 lepers per year would be a low average estimate of the 
number of cases of that disease. 

The greatest period of activity of the disease was between the 
years 1200 and 1500, A. D., and the number of leper homes and 
hospitals reached nearly twenty thousand. 

By the beginning of the eighteenth century, leprosy had 
lost its virulence and had become extinct in the greater part of 
Europe. Today, in certain parts of Norway, Finland, Sweden, 
Russia, and Spain, leprosy maintains a sluggish existence and 
isolated foci of infection are still in evidence. 

From the earliest records of its greatest prevalence, to its 
decline, a period of some five hundred years, Europe is credited 
with having had five million cases of leprosy ; approximately one 
million cases every one hundred years. Apart from its endemic 
prevalence in the before-mentioned countries, occasional sporadic 
cases appear in previous extinct centers even in this twentieth cen- 
tury, and certain families, who, in several generations past had 
been free from the disease, have again been subject to fresh out- 
breaks. 

The tendency of leprosy to cease and then recrudesce is one 
of its dread peculiarities and applies to both locality and person ; 
the victim of the malady is never safe, hence the broad statement, 
"once a leper always a leper." 

In the early part of the middle century period, the house, hut, 
or home of the people consisted of a one-room, one-story dwelling, 
built of uncut stone, laid in a mortar composed of mud, chopped 
straw or rushes, moss or seaweed ; the roof was thatched with 
straw, reeds or rushes, no windows to admit light or air were pro- 
vided ; no board or stone floor was laid, tamped earth, covered 
with rushes or long grass, served the purpose. Houses so con- 
structed, in the light of our present day knowledge, were damp, 
ill-ventilated, and when crowded with human beings and domes- 
tic animals, very unhealthy and uncomfortable. 



52 THE PATH OF THE DESTROYER 

In the cold months of the year, with no provision for ventilat- 
ing and warming these hovels, their contained air would be in 
a prime condition to spread any contagious or infectious disease, 
taken together with the method pursued of distributing the refuse 
food, etc., under the rush or mat floor, this being the most con- 
venient locality for disposing of the sweepings, rubbish and left- 
over food. 

Diseases like typhus, typhoid, tuberculosis, syphilis, leprosy, 
and the exanthemata (eruptive fevers) must of necessity had free 
scope to infect and spread amongst the inmates of these over- 
crowded and insanitary dwellings. 

During the sixteenth and seventeenth centuries changes for the 
better took place in improved conditions of living, food, and bet- 
ter sanitation. The improvement was slow, even the value of sun- 
light and fresh air was not appreciated as late as the nineteenth 
century. A tax on windows, size and number, was in operation for 
several centuries; it was aimed at the foreign glass trade, but it 
discouraged good ventilation. 

The people, learning from costly experience, that cleanliness 
lessened illness, gradually all the old-style disease-producing con- 
ditions were done away with. Stone, tile, or board floors were 
laid; lime for mortar, lime-washed walls, spread on brick or stone 
came into use. Offal, swill, kitchen sweepings and refuse were 
removed from the dwelling house and disposed of in various ways. 

The one-room family residence, used for kitchen, eating-room, 
and for living and sleeping accommodation, gradually was replaced 
by partitioned rooms. Beds or benches elevated from the floor came 
into use, in place of the sleepers lying on the rush-covered, damp 
earthen floor. 

More care was exercised in the selection of fresh food, the 
semi-cooked and often tainted foods of by-gone days being dis- 
carded. Eating with the fingers, probably none too clean, grad- 
ually ceased, and knives, forks, spoons, and plates came into general 
use; and so the disease-spreading habit of passing the food from 
mouth to mouth passed away. 

Surface wells for potable water were dug, a great improve- 
ment on the supply from the polluted village stream, or in those 
days, really sewer, which it was; animals were removed from the 
too near proximity of the living rooms. Pigs, cattle, sheep, etc., 
all were slowly provided with suitable accommodations in out- 
houses. 

Now, as to the leper: gradually he was eliminated from the 



THE PATH OF THE DESTROYER S3 

family circle and removed to a separate room or outhouse, but as 
the disease still remained active and spreading, the Church came 
on the scene, and by means of its dreaded fulminations, roused the 
people to the necessity of ostracising the leper outside the city or 
village. 

It is a significant comparison: (a) the grass house of the 
primitive Hawaiians, "one room, overcrowded and general insani- 
tary conditions," described by many of the early American mis- 
sionaries; (b) the one-room house, mud-plastered walls, earthen 
floor, of the people of Europe, during the ravages of leprosy — these 
conditions existed even in A. D. 1880, in Norway, an endemic 
focus of leprosy. Read what Dr. Danielssen states. 

"In Norway most of the cases of leprosy occur among the 
very poorest classes of the inhabitants, and especially among those 
living around the shores of the deep bays, or fjords, on the west 
coast. The 'huts' of the people generally are of one low, narrow 
room, in which all the family live, with a small window that is 
not made to open, and are usually erected in a damp, unhealthy 
site and surrounded by filth." 

OSTRACISM OF LEPERS 

Ostracism of lepers, suitable to the conditions prevailing in 
the middle ages, was put in force in Europe. 

The leper was pronounced, by edict of the Church, unclean ; 
with him no eating, sleeping, contact or marriage was allowed — 
he was pronounced civilly dead — all these conditions were rigidly 
enforced on all, by Church laws and papal decretal. 

The priesthood kept hammering and dinning the doctrine of 
uncleanliness by bell, book and candle-light ; leprosy was also de- 
nounced as a punishment for some sin committed, and its incur- 
ability was by direct Divine command ; all these fulminations had 
their effect — the people listened. 

When the unfortunate leper was discovered, he was excom- 
municated and ostracised ; the church bell tolled for his living- 
burial, the unfortunate victim was hereafter dead to the world ; 
the rites and burial services for the dead were performed over him. 
the ceremony being carried out at midnight ; he was provided with 
food, clothes, and a coffin was one of his gruesome gifts. 

These harsh and stern measures in dealing with leprosy bore 
fruit ; ecclesiastical weapons were more effective than physic to 
check leprosy. What the doctors failed to do, the Church succeeded 
in doing. 



CHAPTER V. 

LEPROSY AND SYPHILIS 

It has been put forward that when syphilis spread over 
Europe it influenced the general type of leprosy, modifying it, 
and giving it certain new features resembling syphilis itself. 

This contention is too absurd to need any refutation in the 
better knowledge we have of both these diseases in modern times. 
Leprosy is of its own kind. Syphilis is also sui generis. 

About the year 1863, the alleged similarity of the two diseases 
brought about inoculation by syphilis to drive out the leprosy; 
it is needless to say nothing successful came of the experiments, the 
syphilis did not change the character of leprosy a particle. When 
the syphilitic remedies were administered the syphilis was checked, 
and the leprosy remained in statu quo. 

In Hawaii, during the year 1882, the leprosy-syphilis connec- 
tion and the question of the identity of the two diseases came 
acutely to the front, and the controversy assumed quite a popular 
topic of discussion amongst the laity and the medical fraternity 
in Honolulu. 

Dr. George L. Fitch was the leading exponent of the un- 
proved doctrine "that leprosy was the fourth stage of syphilis," 
and a scrofula, hence non-contagious and non-communicable except 
by hereditary transmission. This is no new theory; it had been 
put forward by other members of the medical profession many 
years before Dr. Fitch became one of its disciples and re-propagated 
its tenets with great tenacity and boldness. 

The plausibility and novelty of the statements made impres- 
sed many of the laity and they sided with Dr. Fitch and championed 
him and his cause. I doubt if any other member of the medical 
profession in Hawaii sided with the doctor. He was denounced 
as a charlatan, quack, and a knave in the press, and this arraign- 
ment of the doctor did not suit him; he sued the alleged offending 
paper for libel and was non-suited. This was in the year 1883. 

Dr. Fitch was exceedingly popular with the Hawaiians, the 
court, King Kalakaua and Queen Kapiolani. He gained the inner 
confidence of the Hawaiian people more than any other foreign 
physician that I know of. 

I succeeded the doctor and took up his work at the Leper 
Settlement, and even to the end of my period of service, the lepers 
were always calling for Kauka Pika's (Hawaiian for Dr. Fitch) 



THE PATH OF THE DESTROYER 55 

medicines, and to prove that the people were sincere, money was 
handed me to pay the cost of the medicines. 

Certain members of the medical profession in Honolulu 
assailed the theories of Dr. Fitch in the "Hawaiian Gazette," a 
Honolulu newspaper, in a signed statement, but they made a 
serious error in stating leprosy was an "eminently contagious dis- 
ease," which it certainly is not. This blunder gave Dr. Fitch the 
opportunity to come back hard at his assailants, because two of the 
signers of the letter had sent a leper patient from Honolulu to 
Philadelphia, without any precautions being taken in the transit of 
said patient, although the Honolulu doctors claimed leprosy to be 
an eminently contagious disease. I have dwelt at some length on 
Dr. Fitch and his syphilis-leprosy theory, for it commenced to 
bring Hawaii before the world as a great leper focus. (See Dr. 
Fitch's report, Part Four.) 

Dr. Fitch was one of the most reckless and careless physicians 
in his contact with leprosy, he seemed to take delight in putting 
to proof his non-contagious view of the disease, and was always on 
the lookout for any case where a possibility of inoculation had 
failed to produce it. 

He brought down the wrath of Dr. Arning on his (Dr. 
Fitch's) theory of non-contagion, by alleging that at a certain post- 
mortem on a leper, Dr. Arning had a wound on his finger and 
failed to wear gloves or take an precaution; the wound afterwards 
became infected with septic matter from the leper's cadaver. Dr. 
Fitch claimed Dr. Arning was not sincere, for if he believed leprosy 
contagious he would have acted differently and taken the pre- 
caution to wear gloves whilst making the post-mortems on lepers. 

In the month of July, 1886, Dr. Fitch left Hawaii for good, 
and died at Santa Cruz, California, in June, 1904. Many people 
in Honolulu believed Dr. Fitch had contracted leprosy, owing to 
the careless methods he pursued whilst in contact with the dis- 
ease, and this statement is in circulation today. I know as a posi- 
tive fact that Dr. Fitch did not show a single sign of leprosy to 
the day of his death, which was from hepatic disease. 

I saw him daily for several weeks in San Francisco in the 
years 1890 and 1899. The doctor had heard the stories about his 
being a leper, which were in circulation in Honolulu, and ex- 
hibited himself for medical inspection before myself and other 
physicians in California. 

It is as yet an unproven assumption to state that leprosy and 
syphilis are kindred diseases. Leprosy is definitely known to ante- 



56 THE PATH OF THE DESTROY ER 

date syphilis hundreds of years, records of the disease in China go 
back 6,000 years. Syphilis is of comparatively recent origin, it be- 
came known in Europe and was identified towards the end of the 
fourteenth century as a new disease. It affected poor and rich 
alike, the king, the prince, the prelate, the judge — it spared none, 
and stretched from the artizan's hovel to the steps of the throne. 

It held full sway until towards the end of the eighteenth cen- 
tury, when the mercurial treatment, expounded by John Hunter, 
came into general use and checked the disease. 

Dr. G. L. Fitch maintained that if syphilis was still active 
in its third stage, it then became incurable, passing on to scrofula 
or leprosy, but as to what was the determining circumstances that 
brought, about this change he gave no satisfactory or rational ex- 
planation. 

As a matter of fact, certain specific features present in ter- 
tiary syphilis are clear and distinct, viz. : 

1. Gumma in the liver, lungs, kidneys, spleen, and nerve cen- 
ters; none of these deposits are found in leprosy. 

2. Caries and necrosis of the bones of the skull and long bones 
of the extremities; changes never found in uncomplicated cases 
of leprosy. 

3. Entire ABSENCE of caries and necrotic changes in the 
bones of the hands and feet (Carpus, Metacarpus, Tarsus, Meta- 
tarsus, and the Phalanges) is the rule in syphilis; whereas in 
neural and dual, or mixed leprosy, the destructive bony changes 
of the hands and feet are typically diagnostic of the disease. 

4. Paralysis and muscular changes in syphilis are central in 
origin, whereas the same changes in leprosy are non-central, save 
and except when the leper is infected with syphilis, in such a case 
each disease locates and progresses along lines peculiar and specific 
to itself, but not haphazardly and interchangeably, as the late 
Dr. Fitch and his co-disciples would have us believe and accept. 

Infective leprous neuritis is a purely typical peripheral form 
of nerve lesion causing paralysis, muscular contraction, and anaes- 
thesia; also the peculiar and selective seats of leprous caries and 
necrosis of the bones of the hands and feet are vastly different from 
the osteomyelitis of syphilis and tuberculosis. The resulting changes 
produced by leprosy, leading to mutilation, destruction, and incur- 
able changes in the affected tissues, can in no manner or form be 
made to assume a syphilitic role, either by the pathologist or the 
clinician. 

For hundreds of years leprosy, tuberculosis, and syphilis have 




xm. 



m 




ELDERLY HAWAIIAN WOMAN. 
Niho Palaoa ornament suspended from neck. 



58 THE PATH OF THE DESTROY ER 

been prominent as a destructive trinity of diseases, assuming com- 
plementary relations to each other and progressing pari passu; 
gradually leprosy became supplanted, leaving tuberculosis in al- 
most full possession of the field. 

From the time when syphilis became amenable to treatment by 
mercury, it commenced to lose its severity and wide prevalence; 
apart from its previous incurability and even inoculability, it took 
a bad second position to tuberculosis, which is both inoculable, con- 
tagious, and widely augmented by fresh foci of infection from 
animals. 

ETHICAL PHASES OF HAWAIIAN LEPROSY 

Leprosy in Hawaii from the probable time of its introduction 
is identical with the leprosy of Europe, both of the middle century 
period and today, as we see it in Africa, Brazil, Norway, Spain, 
and the West Indies. 

The conditions, social habits, the non-aversion and ignorant 
contempt displayed by the native Hawaiians for the disease, make 
it appear to be a much more aggravated type than appears in other 
countries where leprosy prevails, and both to the lay mind and to 
many members of the medical profession, leprosy in Hawaii gets 
a more prominent place as a contagious disease than it really de- 
serves. 

Leprologists have expressed themselves as puzzled with cer- 
tain traits and features of Hawaiian leprosy. 

Those leprologists who have never visited our shores, when 
they do so, and first become aware of the conditions existing here, 
soon cease to wonder, and can only express surprise that there are 
not more lepers. This was the feeling with which the great Dr. 
Robert Koch regarded our Hawaiian leprosy. 

After the doctor had spent a week in Hawaii, in the year 
1909, and became conversant with the conditions leading to the 
spread of leprosy, he expressed little surprise and stated: "You 
cannot stamp it out, you might if the disease was curable.'' 

Dr. Robert Koch, bacteriologist of world-wide fame, and Dr. 
Walter Brinckerhoff, bacteriologist and late director of the Federal 
Leprosarium on Molokai (both these gentlemen are now de- 
ceased), became aware of the following facts about the Hawaiian 
race (the chief victims of leprosy), only when they studied the 
disease in Hawaii at close quarters. 

1. Healthy Hawaiians will eat, drink, sleep, and live with a 
leper voluntarily, and without fear. 



THE PATH OF THE DESTROYER 59 

2. A healthy Hawaiian man or woman will marry a leper, 
although there are plenty of well men and women in sight. 

3. In order to lead a lazy, free from care existence, many 
kokuas, or helpers, are willing to become lepers at the Molokai 
Reservation; try to imitate the signs of leprosy by burning their 
skins, rubbing in irritating substances, and by other traumatic 
means, desire to be placed on the list as lepers in order to get their 
daily food free. 

4. In spite of the fact that the main race affected with lep- 
rosy are themselves, the Hawaiians view with ignorant contempt 
the fears of the foreigners, and appear to think that the law of 
segregation is a special device aimed at them only to cause trouble, 
injustice, and break up their homes. The Hawaiians mostly view 
the segregation of their lepers as a tyrannical act, and wholly un- 
necessary, and cannot for the life of them perceive that the said 
law is the only means to prevent their possible extermination. 

5. It has been said in my presence by Hawaiians of the bet- 
ter class, ''Hawaii is our country, it belongs to us, or at least it 
did until the haole got possession of most of it. If the haole is 
afraid of leprosy let him go back to where he came from." 

All these various facts bearing on the spread of leprosy, the 
segregation law and the feeling of hostility to its operation, can 
only be learnt, by close contact with the leper situation, right here 
on the ground, in Hawaii Nei. 

WILL LEPROSY BECOME EXTINCT ULTIMATELY IN 

HAWAII? 

This is a question which no man can answer, an opinion there- 
on must be purely speculative — time alone can decide. 

If we could locate the leper bacillus very early in the disease, 
the problem of extinction would be much simplified. In the five 
cases I have had opportunity to examine the cadaver of the leper in 
the very early stages of the disease, I found advanced leprous 
lesions in the internal tissues of the body ; yet there were only a few 
slight dermal manifestations of the disease — these five cadavers were 
in cases of Nodular leprosy. In the Neural form — take the case 
of the ulner nerve — there is generally extensive deposit in its tis- 
sues, before the loss of sensation in the little ringer, and the wast- 
ing of the interossei muscles show themselves. If the physician 
treating this nerve form of leprosy will reflect on what I have 
written, it will be more apparent to him why electrical treatment 
fails to give better results in muscular atrophy and the tonic flex- 



60 



THE PATH OF THE DESTROYER 



ing of the fingers on the palm, in the supposed early stages of the 
disease. 

Hawaii has been peopled by emigrants from many countries, 
and from many of these countries the emigrants often bring latent 
leprosy, which subsequently develops in Hawaii. Japan, China, 
Korea, Philippines, India, many islands of the Pacific, the Azores 
in the Atlantic, Cape de Verde Islands, the West Indies, Brazil, 
and other South American countries, have all furnished new foci 
of leprosy for Hawaii. 

Emigrants from these various countries have developed lep- 
rosy soon after taking up residence in Hawaii, and have frequently 
claimed that they acquired the disease after entering the country, 
in order to save being deported to their original homes. 

Hawaii claims to be the "Cross-roads of the Pacific," and 
hence is especially liable to have diseases brought to her shores. 
Possibly for this reason alone, leprosy may continue to be an en- 
demic disease of the islands for many years to come. 

The many insuperable difficulties that bar the way to com- 
plete segregation, especially the character of a segregation "that is 
permanent, and for life," and the almost mono-race prevalence of 
the leprosy, all react unfavorably and tend to prevent speedy ex- 
tinction of the disease in Hawaii. 
Table of nationality of foreign lepers at Kalihi station, Oahu, and 

the Molokai Settlement, taken from the Board of Health 

statistics, 1912. 



NATIONALITY 



1. American 

2. British Negro 

3. Chinese 

4. Filipino 

5. German 

6. Japanese 

7. Korean 

8. Porto Rican 

9. Portuguese 

10. Russian 

11. South Sea Islander 

12. Swede 



MALE 



5 
2 

31 
3 
2 
7 
5 
1 

32 
1 
1 
1 

91 



FEMALE 


TOTAL 




5 





2 





31 





3 


3 


5 




7 


.... 


5 




1 


11 


43 




1 





1 




1 


14 


105 



THE PATH OF THE DESTROYER 61 

These figures do not show all the foreign lepers domiciled in 
Hawaii, many are deported, or return of their own free will to 
their original homes. 



Does Hawaii furnish any clue that will aid to explain the 
gradual disappearance of leprosy from Europe? 

No clue exists in the leprosy situation in Hawaii up to the 
present day, that will aid us in arriving at the solution of the 
cause of the almost total disappearance of the disease in Europe. 
Our methods of segregation, I have repeatedly stated previously, 
have been so faulty that no definite reliable statement can be made. 
The question may be asked, however, "What material effect has 
segregation had in preventing the spread of leprosy in Hawaii?" 

I answer it must have had some effect, but it has not accom- 
plished what the general public and many members of the medical 
profession expected forty, thirty, and twenty years ago. The vari- 
ous back reports of presidents of the Board of Health are highly 
optimistic; they sing the same tune, "the end of segregation is in 
sight, a few more years we will see the last of it." Alas! these 
predictions have not borne fruit; we still in Hawaii have as yet 
a continuous source of leprosy from the aboriginal Hawaiians, who 
are decreasing yearly; it looks on the face of it as if the ratio 
of lepers is falling off (owing to the decrease of the Hawaiian 
race) and that alone is the cause of the decrease of leprosy (if 
there is any decrease) and not segregation. 

There are three prominent factors decreasing the disease, viz. : 
"Increasing Immunity, Non-heredity, and Segregation," they will 
succeed. 

We must turn about and look at what imperfect segregation 
has done for Norway. 

In twenty-four years, by segregation (not rigid by any means). 
Norway decreased her lepers 45% — from 2,863 lepers to 1,582. 

* * * 

Leprosy is stated to have become extinct because it was non- 
contagious in Europe. 

Why has leprosy made such a rapid spread in Hawaii, if if 
is non-contagious? 

If segregation causes a diminution in a disease, and not treat- 
ment and sanitary measures, it looks to me that when contact 
with that disease causes it to spread, when the contact is not 
made possible or lessened (even in faulty segregation), and the 



62 THE PATH OF THE DESTROY ER 

disease diminishes, is it an arrogant assumption to claim it is 
contagious t 

Leprosy, when it invades new fields, makes the same rapid 
spread, in all the countries, where the leper has been allowed to 
mingle at large with the people. Hawaii, and more recently South 
Africa, afford eloquent testimony of the truth of this statement. 

Leprosy per se is limitedly contagious, and tends to become 
extinct. In India it is maintained and nourished by chronic care- 
lessness on the part of some fraction of the population in contact 
with the disease, from generation to generation. The great ma- 
jority of the people in India, China, and Japan take precautions 
and avoid exposing themselves to direct contact with the leper. 
Caste, religion, non-eating with lepers, etc., all play a part in pre- 
venting the spread of leprosy and are just as efficient as faulty and 
imperfect segregation. Touching, eating, sleeping with a known 
leper, all these intimate and direct contacts, are sedulously avoided 
by the Mohammedan races. 



CHAPTER VI. 

THE RUDIMENTS OF SEGREGATION 

The Act to prevent the spread of leprosy by segregation be- 
came law January 3, 1865, and shortly after on the 31st day of 
January, at the first meeting of the Board of Health, the subject 
of leprosy came up for discussion, and the establishment of a 
hospital was determined upon. 

The members of this Board were: President (ex-officio), the 
Minister of Interior, Chas. G. Hopkins; members, W. Hille- 
brand, M. D., F. W. Hutchison, M. D., W. P. Kamakau; sec- 
retary, T. C. Heuck. 

A site in Palolo Valley was subsequently decided upon as 
most suitable for a temporary hospital for lepers, and this site was 
purchased for $1,000 on March 17, 1865, but was never used, 
owing to the protests of adjoining residents. On April 3, the 
Board appropriated $15,000 for a hospital for lepers. 

On June 10, two propositions came up before the Board, 
the Hon. Godfrey Rhodes sitting as president: (1) a settlement 
for light cases near Honolulu; (2) for the incurable cases, land 
on the north side of Molokai, the suitability of the site of the 
present Leper Settlement being discussed. 

A lot at Kalihi, about two miles from Honolulu, on the 
west side of the harbor and adjacent to the seashore, was chosen 
as a hospital for light cases and a temporary detention station for 
severe cases of leprosy. This lot, containing about twelve acres, 
was subsequently purchased for $665, and when the accessory 
hospital buildings were erected this station was known as the 
Kalihi Hospital and Detention Station. It was opened for the 
accommodation of patients on November 13, 1865. 

Dr. E. Hoffman was appointed physician November 3rd, at 
a meeting of the Board of Health ; the Board also issued the fol- 
lowing proclamation addressed to lepers : 

"NOTICE BY THE BOARD OF HEALTH 

"Whereas, The last Legislative Assembly enacted a law en- 
titled 'An Act to Prevent the Spread of Leprosy,' which said law 
requires the Board of Health to take such measures as in their 
judgment shall be deemed expedient to endeavor to cure those 
persons who are afflicted with the disease, and to protect the public 



64 THE PATH OF THE DESTROYER 

at large against contagion, at the same time fully empowering the 
said Board to carry out the purposes set forth in said act; 

''Therefore, all persons who are affected with leprosy, or who 
are suspected to be affected, are hereby notified. 

"That the Board of Health has established a hospital with 
suitable buildings at Kalihikai, on the Island of Oahu, about 
two miles from the city of Honolulu, where persons afflicted with 
leprosy will be inspected and medically treated, as well as care- 
fully attended, with a view of effecting a cure. This hospital is 
carefully arranged by the Board in order to ensure proper atten- 
dance and nursing of the patients, and at the same time to endeavor 
by all possible means to cure the disease with which they are 
afflicted. 

"To this end the Board will secure the best material and 
medical aid, and will carefully watch over the welfare of such 
lepers as may be committed to the hospital. 

"Time and experience will best prove the proper course to be 
adopted hereafter, but for the present it is the intention of the 
Board to require that all cases of leprosy shall be removed to the 
hospital at Kalihikai for examination. All those who are reported 
as lepers, but found to suffer from other cutaneous diseases, will 
receive advice and medicine and be either allowed to return to their 
homes, or receive medical treatment under the orders of the Board. 

"All cases of leprosy of which it is considered practicable to 
effect a cure will be required to remain at the hospital, in order 
to be properly treated and attended. 

"All such lepers as are in an advanced state of the disease, 
and liable to endanger the health of others who may come in con- 
tact with them by spreading the contagion, will be required to 
remove to the settlement at Kalaupapa on the island of Molokai, 
which has been set apart for that purpose by the Board, and where 
all possible care will be extended to them. 

"In accordance with the foregoing rules, the Board of Health 
hereby notifies all persons who may be affected with leprosy, to 
hold themselves in readiness to obey the direction of the duly 
authorized agents of the Board, as to the time and mode of remov- 
ing to the hospital at Kalihikai. Of this, proper and full notice 
will be given, and the Board relies upon a prompt compliance with 
the provisions of the law, and the rules and regulations issued for 
carrying the same into effect. 

"All public officers, when called upon, and the public gen- 



THE PATH OF THE DESTROYER 65 

erally are requested to assist in carrying out these sanitary measures, 
so manifestly tending to the benefit of the public. 

. "T. C. HEUCK, Secretary Board of Health. 

"Office Board of Health, October 25, 1865." 

Kalihi hospital continued in operation some ten years, and 
was abolished in the year 1875 for the following reasons: 

1. Great expense of the upkeep. 

2. Isolation was found impossible. 

3. Failure to effect any cures. 

It was also decided that all persons who had leprosy should 
at once be sent to Molokai, and to this end a suitable building 
adjoining the police station was erected, where suspects were de- 
tained until such time as the medical examiners decided whether 
they were lepers or not. 

ESTABLISHING OF THE MOLOKAI SETTLEMENT. 

At the meeting of the Board of Health held on June 10, 
1865, a suitable location for a settlement for incurable cases of 
leprosy came up for discussion, and the suitability of land on the 
north side of Molokai was to be looked into. 

At the meeting of the Board of Health held July 6, 1865, the 
Hon. Godfrey Rhodes, president, was authorized to inspect the land 
on the north side of Molokai, Kalawao, and if suitable to procure 
the same for the purpose of establishing a settlement thereon. 

At a meeting of the Board of Health, held September 20, 

1865, the president reported that he had visited the island of 
Molokai, and had purchased the lands of Kalawao and Waileia, 
some 800 acres for about $1800 cash with some other government 
lands given in exchange. 

The adjoining westerly land Makanalua was also purchased 
at this time, and the Ahupuaa of Kalaupapa in the year 1873 
came into the hands of the Board of Health. 

The first shipment of lepers landed at Kalaupapa, January 6, 

1866. This was the beginning of segregation and banishment of 
lepers to the Leper Settlement on Molokai. 

The leper detention station, which was erected adjacent to the 
police station on King Street, after the closing of the Kalihi leper 
hospital, was abolished on the opening of a new leper hospital at 
Kakaako, on December 12, 1881. This new hospital was situated 



66 THE PATH OF THE DESTROYER 

on the east side of the harbor of Honolulu, on the sea shore about 
one mile towards Diamond Head. The site was very unsuitable; 
high tides, especially with south wind, caused the hospital grounds 
to be inundated by the sea, and after being in existence some eight 
years, about the year 1889 the hospital buildings were moved 
back to Kalihi, to a site at or near the old Kalihi hospital which 
had been closed in the year 1875. 

This new Kalihi leper hospital is in existence, and in active 
operation today, and fills the double office of a detention station 
and hospital, where mild cases of leprosy are treated, all confirmed 
and advanced cases being sent to Kalaupapa, Molokai. 

LANDS COMPRISING THE LEPER SETTLEMENT. 

Kalaupapa — The Leafy Plain or Flat. 

Kalauwao — The Leafy Wilderness. 

Makanalua — The Given Grave or Pit, because the lake at 
the bottom of the crater of Kauhako was suitable for, and was 
used as a burial place for the dead. If the corpse sank it was a 
good omen, and was proof that the body was acceptable in the 
Nether Regions; if the corpse floated it was interpreted as a bad 
omen, indicating that the corpse was not acceptable to the plutonian 
aristocracy. 

Kauhako the crater of Makanalua is located about a mile in- 
land from the nearest ocean contact, and contains a lake of semi- 
brackish water, its degree of saltness depending on rain-fall and 
high or low tide; it is potable. The surface of the lake rises and 
falls with the tide, and has an area of some 5,000 square feet. 

At low tide, on the mountain or mauka side of the lake, there 
occurs a considerable inflow of sweet water from the drainage of 
the Waihanau (origin or birth of water) basin. This fresh water 
some three feet in depth is buoyed up and floats on the surface 
of the underlying body of salt or ocean water, and the color divid- 
ing line of these two bodies of water is distinctly visible to the 
eye from the surface or on diving. 

Sounding from a canoe in the month of October, 1886, I 
found no bottom at 600 fathoms. Mr. and Mrs. Ambrose Hutchi- 
son aided me, the latter swimming for two hours in the lake, to 
prevent the fouling of the line, and the tipping over of the canoe 
from the heavy drag of the sinker and sounding line. 

The greatest elevation of Kauhako is some 493 feet above the 
sea; the lake in the bottom is 10 feet above sea level. 




THE LEPER SETTLEMENT. 



Comprised of three sections of land or ahupuaas — Kalaupapa, Makanalua, 
and Kalawao. The water supply is derived from Waikolu Valley. 

Longitude 156° 58' W, cuts the center of this peninsula due north and 
south, latitude 21° 11' N. cuts it due east and west. Average yearly rainfall, 
89 inches. Average winter temperature 70° Fahr. Average summer tem- 
perature 76° Fahr. 

The land comprising the Leper Settlement is of more recent origin than 
the main portion of the island; it has been formed by clinker lava, or aa, 
ejected from the adjacent crater of Kauhako. 



68 THE PATH OF THE DESTROYER 

One of my desires in sounding the lake of Kauhako was to 
ascertain the source of the ocean's feed to this lake, by lava tunnel, 
or seepage, also to learn if it was feasible to shut off by earth, or 
cement dam, the incoming salt water. If this could be done a 
considerable body of water, some several million gallons, would be 
available daily by siphoning, for the supply of the Leper Settle- 
ment. 

I discovered that Kauhako lake was the extreme apex of a 
throat or funnel some 30 feet in diameter, gradually widening out 
to unfathomable space and depth; a condition which put the damper 
on the possibility of obtaining a supply of water from this source. 






CHAPTER VII. 

PRACTICAL WORKING OF THE LAW OF 
SEGREGATION. 

The general care and welfare of the leper is better carried 
out in Hawaii than any other country of the world. This state- 
ment is beyond question. The Leper is a chronic hospital patient, 
a life long one, and the people of Hawaii have nobly met this idea 
by appropriating sums of money away up in the millions of dollars, 
which have been expended for the care and support of the leper in 
segregation. 

As long as the country continues in a prosperous condition 
every nerve and sinew will be strained to combat the disease. 

Reader, bear in mind "The condemning of your fellow men, 
women and children to isolation and involuntary imprisonment for 
life, to benefit the healthy;" how many realize what this means? 
Do not be too hypercritical and condemn a system loopholed with 
faults. ^ 

Segregation is the only means left to a community in dealing 
with a known spreading, incurable disease, even if limitedly con- 
tagious. 

It is true leprosy is no crime, a ridiculous issue raised by de- 
signing and scheming politicians in Hawaii, nevertheless, for the 
benefit of the healthy, and the general rule, "the greatest good to 
the greatest number;'' the leper is practically condemned to life- 
long imprisonment of a certain form, not absolute restraint within 
prison walls, but he is banished to a delightful tract of land on the 
north or windward side of the island of Molokai, bordering on 
the ocean, where he can enjoy fine air, sunshine in abundance, and 
genial surroundings, all the comforts of home, perfect freedom 
alone lacking, which, even if the majority of lepers wished to avail 
themselves of, they could not, their disease crippling their bodies 
and preventing locomotion. 

The personnel of the Board of Health for many years has in 
the main been composed of foreigners. The Territorial Board of 
Health consists of seven members, three laymen, three physicians, 
and the attorney-general of the Territory, ex-officio. The members 
of the Board are appointed by the governor of the Territory. The 
Board elects is own president, by, and with the consent of the 
governor ; four members present constitute a quorum ; all the mem- 



70 THE PATH OF THE DESTROYER 

bers of the Board are unpaid; the president has a salary appropri- 
ated by the Legislature, and may be a layman or physician. 

For many years past sixth-sevenths of the members of the 
Board of Health have been comprised of foreigners — six of these 
and one Hawaiian; there are many reasons for this, I state a few: 

1. The Board of Health and its officials are not too well loved 
by the Hawaiian people. 

2. The appointment as a member of the Board carries no 
salary. 

3. A native Hawaiian member of the Board of Health will 
certainly not command the votes of the pure Hawaiian race, no 
matter how popular he is. 

For all of the above reasons (and many others I dare not 
mention in print), the unpopularity of the Board of Health is due, 
sometimes to true and legitimate causes, sometimes the fault found 
with the acts of the Board have no justification; it is an inability 
to comprehend the situation that causes the hostility. 

The good intent of the rules, laws, and regulations of the 
Board of Health are often frustrated by the lack of tact and 
undue harshness of the executive officers carrying out these rules. 
This has happened in several instances, where the enforcing of 
segregation has ended in murder and bloodshed, the absence of 
violent opposition being in the main due to the GENIAL, KIND- 
LY GOOD-NATURE of the Hawaiian people, who are not 
easily provoked to anger, and its ally personal violence. 

The armed resistance to the leper segregation law that took 
place on the island of Kauai in the month of July, 1893, in Kala- 
lau Valley, is an instance of gross lack of tact and diplomacy on 
the part of the Board of Health and its executive; neither can 
escape the criticism "of doing the right thing at the wrong time." 
The then Kingdom was silently in a state of civil war, and race 
hatred at white heat, due to the ousting of Queen Liliuokalani 
from her throne by the foreign element in Hawaii. 

The time was most inopportune for breaking up a leper camp 
in Kalalau Valley. 

The lepers in this camp were fed and cared for by their 
friends and relatives, and were just as much segregated from the 
rest of the community as the thirty-nine kamaainas (old residents) 
at the base of the Kalaupapa Pali, who, for twenty-nine years, 
were allowed access to and permitted to wander about the Leper 
Settlement on Molokai. These said kamaainas were finally ejected 
from their holdings in January, 1895. 



THE PATH OF THE DESTROY ER 7 i 

When the Leper Settlement first began to be peopled with 
lepers in January, 1866, many of the kuleanas (or homesteads) of 
the old residents were not purchased or condemned. The residents 
on these kuleanas continued to reside on them for twenty-nine 
years, and during all this time mingled freely with the lepers, aided 
the well friends of these lepers in their clandestine visits to the 
Settlement, affording them food and lodging. This, of course, was 
a loophole in supposed rigid segregation, and is a conspicuous in- 
stance showing where efficient segregation was lacking for three 
decades on Molokai. 

SHOOTING OF DEPUTY SHERIFF SIMEON 

In the month of September, 1890, I was living in North Kona, 
Hawaii, when the following occurrence took place. 

On the mountain side, about two miles above the village of 
Kailua, resided a certain Hawaiian male, Kealoha, who had lep- 
rosy; his removal was decided on, and Deputy Sheriff Simeon, a 
native Hawaiian, and two other Hawaiian police officers proceeded 
to arrest him. The police knew he was armed with two rifles, as 
he had refused to surrender on demand some weeks before. 

The police had no warrant for the man's arrest, went armed, 
approached the premises of the leper along a narrow path wide 
enough only to admit one man at a time, and when in close prox- 
imity to the house, remained altogether, instead of surrounding the 
house and taking cover. The police hailed the leper and requested 
him to come out and surrender. He refused, and the next mo- 
ment opened fire at a range of seventy-five feet with a smooth-bore, 
old-fashioned rifle. As a result, Simeon, the sheriff, was shot through 
the stomach and killed. (The government had to pension his 
widow for many years.) The leper, Kealoha, again opened fire 
with a repeating Winchester rifle, the ball ploughed its way along 
the muscles of the forearm, from elbow to wrist, of one of the 
policemen, then the officers ran away; subsequently the leper gave 
himself up. 

He told a story of being fired at first by a volley from the 
revolvers of the police, who denied firing a shot. The truth of 
the leper's story was evident, he had a bullet wound in the leg 
from a 38-calibre revolver; the bullet was extracted by the attend- 
ing physician. The leper died in the jail shortly afterwards. 

There have been possibly about a dozen cases of lepers re- 
sisting deportation to Molokai by the use of firearms during the 



72 THE PATH OF THE DESTROYER 

past thirty years, but generally no resistance of a violent char- 
acter is offered to the segregation law. 

Occasionally the courts are used to prevent deportation, and 
writs of habeas corpus are issued, but these legal proceedings are 
few and far between, and are just as often stirred up by some 
designing doctor, lawyer, or other party looking for a fee and 
notoriety. 

THE LEPER WAR ON KAUAI 

The most serious and successful armed resistance offered to 
the enforcement of the leper segregation law took place at Kalalau, 
a large valley on the northwest shore of the island of Kauai, in 
the first week of the month of July, 1893. 

On Monday afternoon, the 5th day of June, 1893, I was 
closeted with Edward G. Hitchcock, marshal of the Hawaiian 
government under the then Provisional Government, in his private 
office in the police station, Merchant Street, Honolulu. 

I am now the only living person who overheard this conversa- 
tion. The speaker was Marshal Hitchcock, and he was addressing 
a slim built man about thirty-eight years of age. 

"Stolz, you better wait a little until I can spare you some 
of my foreign police officers, you cannot trust your Hawaiian offi- 
cers, just as things are at present. You are foolish to think of 
going alone to Kalalau, because I hear the people and lepers in that 
valley are practising target shooting. Let this leper business go 
over for the present, we are not yet out of the woods in Hono- 
lulu. This Cleveland and Blount business is a d — n nuisance.'* 

The man addressed had been hurriedly ushered into the mar- 
shal's office while I was present, and he was introduced to me as 
Deputy Sheriff of Kauai, living at Waimea. His name was L. H. 
Stolz, and his subsequent tragic ending impressed deeply the above 
conversation on my mind. 

A few words about the personality of the late Marshal E. G. 
Hitchcock will not come amiss. His chief work was as sheriff of 
the island of Hawaii, which office he held for about nine years, 
from May, 1888, onwards. He died on Sunday, October 9, 1898, 
at Waimea, Hawaii, aged sixty-two years; at the time of his death 
he held the office of circuit judge. 

To Sheriff Hitchcock must be given the credit of clearing the 
island of Hawaii of its lepers, especially the Kona district, where 
lepers were allowed to remain unmolested for many years. Over 
400 lepers and suspects were ferreted out during his term of office, 



THE PATH OF THE DESTROY ER 73 

he never flagged, was tireless and unrelenting in enforcing the leper 
segregation law. He expressed himself to me as follows: "If 
leprosy can be stopped by getting all the lepers to Molokai, I pro- 
pose to keep going after them until I get them all." 

Sheriff Hitchcock was thoroughly honest and easily the most 
efficient all-round officer who ever held the position of Marshal of 
the Kingdom. He played no favorites, he cringed to none, and 
asked no favors or advice from anyone, he had good legal knowl- 
edge; though hasty and impetuous in speech and manner, he rarely 
erred, was always resourceful in an emergency, was rarely cor- 
nered. His quick and efficient methods of dealing with criminals 
and law-breakers obtained for him the sobriquet of "The Holy 
Terror" — it was especially suitable. 

THE TRAGEDY OF KALALAU 

The advice given to Deputy Sheriff L. H. Stolz by Marshal 
Hitchcock in the latter's office I have already related. It was also 
further supplemented by the marshal's stating, "You wait a month 
01 two longer, then I will come up to Kauai and see how the 
land lays." Stolz answered, "Kalalau is surf-bound at the end 
of September, and after that the pali is the only way to get into 
the valley." Hitchcock answered, "No pali phases me, I was born 
on Molokai, and we have some palis up there. Dr. Mouritz is a 
great climber, ask him." 

On Deputy Sheriff Stolz's return to Kauai he evidently de- 
termined to tackle the leper problem in Kalalau alone, as his sub- 
sequent, action proves. 

One evening early in the month of July, Stolz arrived in Kala- 
lau about seven o'clock. He was armed with a 45-70 Winchester 
magazine rifle, made his business known to the people, and asked 
for the whereabouts of one Koolau, a young Hawaiian about twenty- 
four years of age, said to be a leper. This man was a reputed 
excellent marksman, and he subsequently showed that he well de- 
served this reputation. Some of the residents of the valley pre- 
tended to show Stolz where Koolau was and they accompanied him 
part of the way; meanwhile Koolau was expecting Stolz, he (Koo- 
lau) always carried a rifle, and no doubt was speedily informed of 
the arrival of the sheriff. I firmly believe the unfortunate sheriff 
was purposely led into an ambush by his would-be guides. 

Koolau suddenly appeared from behind a rock some 200 feet 
up the trail, which the native guides, with Stolz in advance, were 



74 THE PATH OF THE DESTROYER 

following. The challenge came from Koolau. "Stolz, you have a 
gun, are you after me?'' Stolz answered: "Yes." Koolau then de- 
liberately rested his rifle on a rock and shot Stolz through the 
stomach. He fell and straightened up to a sitting position, vainly 
striving to aim his rifle, waiting for Koolau to show himself from 
behind the rock which hid him. 

In the gathering darkness Koolau called out to the Hawaiians 
near Stolz: "Is he dead?" They answered "No," then Koolau 
filed again, the bullet striking Stolz between the stomach and heart, 
he keeled over dead on the narrow trail he had been following in 
pursuit of Koolau. 

News of the shooting of Stolz was carried over to Waimea the 
next day, and a steamer brought his body from Kalalau to Honolulu. 

This story of the shooting of Deputy Sheriff Stolz came to 
me from the lips of eye witnesses, some of whom were with Koolau. 
They were lepers, and I met them at Kalaupapa three months after 
the shooting. 

EFFORTS TO CAPTURE KOOLAU ENDS IN THE 
SHOOTING OF THREE SOLDIERS 

In Honolulu the killing of Sheriff Stolz created quite a stir, 
and the government immediately took steps to effect the capture 
of the leper Koolau with a squad of soldiers, who had been en- 
listed when the provisional government assumed office, after the 
ousting of Queen Liliuokalani from the throne of Hawaii. 

It having been reported that a number of lepers in Kalalau 
Valley had joined Koolau, were well armed and were also con- 
versant with all the trails and the general features of Kalalau 
Valley (some nine miles long and densely covered with semi-tropi- 
cal vegetation, precipitous sides, and in places inaccessible and 
perpendicular palis). Recognizing all these difficulties, a squad of 
some twenty-five soldiers and a portable field gun were sent to 
Kauai. 

Koolau was located some miles up the valley. He had no 
companions except Piilani, his wife, and their little son, who was 
also a leper. He had plenty of ammunition, several rifles and a 
supply of food. 

The position of Koolau's camp was situated on the side of the 
valley, some 600 feet above its floor, on a narrow ledge difficult 
of access, amongst dense vegetation, and at close quarters one de- 
termined man could hold off a company. 



THE PATH OF THE DESTROY ER 75 

Koolau was invisible, but he could pick off his pursuers at will 
when they attempted to scale the ledge on which he was hiding, 
and no opportunity could be had to return Koolau's fire, except 
from a position above him, which the soldiers never succeeded 
in gaining. 

One soldier, Anderson, was shot through the lungs by Koolau 
the second day after the arrival of the squad, and died on the 
spot where he fell. Another soldier, McCabe, a veteran of the 
Civil War of 1861-65, was shot through the brain the day after 
the killing of Anderson, and one other soldier was found shot, with 
a bullet wound under the chin, the bullet passing upwards through 
the brain and making exit through the vault of the cranium. 
Whether Koolau was responsible for the killing of this soldier is 
doubtful. The field piece, owing to the rough and rugged nature 
of the country was of no real service. 

Due to the losses of these three men, and there being no pros- 
pect of capturing Koolau, the squad of soldiers was ordered back 
to Honolulu. Koolau was never captured or seen again outside of 
the valley, and died about five years afterwards of leprosy in Kala- 
lau. His rifle was subsequently recovered and is in Honolulu in 
the police station's collection of arms. 

THE ASSASSINATION OF DR. JARED SMITH 

Indirectly due to the successful resistance of Koolau to 
arrest and deportation to Molokai, came another calamity some 
four years afterwards in September, 1897. This occurrence also 
took place on the island of Kauai, at Koloa, and caused the death 
of Dr. Jared Smith. The island of Kauai had always been re- 
markably free from crimes of violence until these troubles occurred 
due to enforcing the segregation law. 

One evening about nine o'clock in the month and year before 
stated, the doctor was called by a loud knocking at his door, when 
he answered the call he was immediately fired upon by a native 
Hawaiian. The doctor was shot through the lungs in proximity to 
the aorta, and his death took place instantaneously. 

The alleged cause for the shooting was to prevent the doctor 
signing an order for deportation of a certain alleged leper girl 
to Honolulu. The murderer was shortly after apprehended and 
tried for first degree murder, was convicted by the jury and hung. 

Dr. Jared Smith was a child of Hawaii, being the son of one 
of the early American missionary families ; he had the reputation 



76 THE PATH OF THE DESTROYER 

of being kind-hearted and inoffensive in manner, and was a gen- 
erous donor to the poor Hawaiians. 

The shooting of the doctor was not traceable directly to en- 
forcement of the leper segregation law, he alone had no power to 
consign any leper to Molokai. 

This power of declaring a leper incurable and consigning him 
or her to Molokai, rests with a committte or commission of five 
physicians. Further information on this matter can be found on 
another page of this book, amongst the laws relating to leprosy. 
The murder of Dr. Smith was the act of a fanatic. 

"The smoldering flame of malice aforethought, nursed in the 
mind of his murderer, due to the successful resistance to the law 
carried out by the leper outlaw Koolau, in Kalalau Valley, accounts 
fully for the committal of the deed." 

MURDEROUS ASSAULT ON THE POLICE AT 
KALAUPAPA 

Of quite a different, nature, and quite unique in the facts 
leading up to the tragedy, was the murderous assault on the police 
at Kalaupapa, Molokai, the western village of the Leper Settle- 
ment. This happened about 7 :30 p. m. on the evening of Oc- 
tober 29th, 1885. 

It is well known many children, the offspring of lepers born 
at the Leper Settlement, grow up and show no signs of leprosy, 
even though both parents are lepers. (So much for the alleged 
hereditary nature of the disease.) Most of these children, both 
boys and girls, are often left orphans, and their care devolves on 
others. Almost invariably the Hawaiian people are fond of chil- 
dren, and the foundling or stranger receives the same care and 
love as one of the family. 

Thirty years ago there were many orphans at the Leper Settle- 
ment in the care of Kokua families, but most were cared for by 
the Catholic mission, under the supervision of Father Damien, at 
Kalawao, and I claim this was one of the finest works that this 
priest undertook and carried out. 

Father Damien's orphanage was comprised of thirty orphan 
boys and twelve orphan girls, and more than half these children 
had a leper father and also a leper mother. Lest I forget to 
state, fourteen of these orphan girls were removed from the Settle- 
ment in the year 1885, to the Kapiolani Home at Kalihi, Hono 
lulu, Oahu, and only one had to be returned some years later as 




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78 THE PATH OF THE DESTROY ER 

a leper to Molokai. The thirteen others are now over forty years 
of age, have married, had families, and neither the mothers (these 
orphan girls from the Leper Settlement) or their children have 
developed leprosy. (Heredity as a cause of the reproduction of 
leprosy, takes a back seat in this instance.) 

It was determined to remove these orphan children from 
Molokai, where there was no schooling, absence also of other 
suitable conditions for growing girls, and ever present the menace, 
and every possibility and chance of infection with leprosy. 

The Kapiolani Home for orphan girls, children of lepers, 
was to be formally opened and dedicated on November 9, 1885, 
fourteen orphan girls had to be selected, carefully examined for 
absence of leprosy, and sent as the first occupants of the Home, 
their presence being desired at the dedication ceremony. 

The officials connected with the Leper Settlement were form- 
ally notified of the desires of the Board of Health the third week 
of October, 1885. 

Weeks before this, the intended removal of the orphan girls 
was the sole topic of conversation. Much speculation was indulged 
in, sinister motives were imputed to the Board of Health and its 
officials in the proposed removal. 

I may state here, lepers to the number of 800 or more re- 
siding at Kalawao and Kalaupapa will have 800 correspondents 
scattered all over the group, local news from hamlets and villages 
all over the islands, from Niihau to Hawaii, speedily filters into 
the Leper Settlement, which also acts as a general clearing-house 
for news for the entire group. 

The officials of the Leper Settlement received orders to tran- 
ship fourteen orphan girls to the new Kapiolani Home, only suffi- 
cient accommodation being provided for this number. In making 
the selection, considerable and unexpected opposition was met with 
from three points : 

1. The rules of the Board of Health allow no ration for a 
kokua, male or female, but a child born at, the Settlement, whether 
clean or leper, by reason of this birthright, draws rations. None 
of these orphan girls were over fourteen years of age, and most of 
them provided the kokuas they lived with a Board of Health ration. 
The girls were made to act as household drudges, doing the wash- 
ing, ironing, also the work of the whole family; hence if the orphan 
girl was removed from a kokua family, thereafter that family must 
go hungry, the orphan girl or girls (sometimes several in a family) 
being the sole support of the family, the foster parents (kokuas) 



THE PATH OF THE DESTROYER J) 

living entirely off the food of the orphan and making no effort to 
augment it! 

2. Sometimes a leper family adopted an orphan child or 
children into their home, and had their rations increased accord- 
ingly, and when the prospect of losing the rations of these children 
became apparent, strong objection was made. 

3. Father Damien had become very much attached to his 
family of forty-two orphans, twelve of the children being orphan 
girls, and he strenuously objected to any inroads being made on his 
orphanage, and suggested that none of the children in his home 
be removed until all the orphan girls living with kokuas and 
lepers had been deported. 

Naturally all these objections carried little weight with the 
executive officials of the Settlement; there was a feeling of dis- 
content and some doubt or uncertainty lest trouble might arise, but 
duty must be performed. 

With the aid of Deputy Superintendent A. Hutchison, four- 
teen girls as near the age of fourteen as possible, were selected 
wherever they could be found; objections from Father Damien, 
kokuas, lepers and other interested parties were all brushed aside 
and ignored. 

The placid, even tenor of the Settlement life was raised to 
one of tension and excitement during the last week of October, 
1885. 

Although everything was in readiness, the Board of Health, 
doing the right thing at the wrong time, sent the steamer too late 
for daylight shipment- of the girls. October is a surf month at 
Kalaupapa, and efforts to induce the captain of the steamer to 
await morning failed, he claimed his orders were to reach Hono- 
lulu at daylight, so the shipping of the girls began about two 
hours after sunset, in darkness — then the bolt fell, and another 
leper tragedy happened in the twinkling of an eye. 

THE TRAGEDY ON THE CAUSEWAY AT KALAUPAPA 

Amongst the little orphan girl deportees of leper parentage 
was one Abigail, about eleven years of age; she had two foster 
fathers, Lohiau and Momona, men of middle age and of powerful 
build, their leprosy not far advanced. These two lepers had made 
threats against the police several days before the date of the sup- 
posed departure of the steamer with the orphan girls; had sharpened, 
and were seen sharpening, butcher knives. These men openly stated 
they would resist by force the removal of Abigail. 



80 THE PATH OF THE DESTROYER 

Several of the girls had said good-bye to their friends, with 
the usual loud Hawaiian wailing, filling the air. Abigail's little 
flimsy trunk was being carried by Momona, he was halted by Dep- 
uty Sheriff Kanohoahu and police officers Mahiki and Kaumualii. 
Lepers were not supposed to have contact with the boat's crew (to 
prevent smuggling of opium or intoxicating liquors), they could 
come down the causeway leading to the then primitive wharf, but 
no further. 

The police passed Abigail along to the boat, Momona wished 
to carry the little girl's trunk, but the officers held him up and 
attempted to take the trunk from his hand. He resisted, and in 
the struggle the lid of the trunk opened and its contents, the 
girl's clothes, fell into the sea. 

Lohiau, carrying a knife in his hand, unperceived in the dark- 
ness, stabbed Kanohoahu twice in the pit of the stomach, and 
Momona, dropping the trunk, also drew a knife and stabbed 
Kanohoahu back of the left clavicle, cutting the subclavian artery 
and piercing the lung. Efforts to wrest the knife from Lohiau 
ended in his giving a back twist of the weapon, which entered the 
abdomen of Kaumualii and reached the spleen. Mahiki grappled 
with Momona, and in the struggle for possession of the knife was 
stabbed in the right groin, cutting the profunda femoris artery. 

Kaumualii died of acute peritonitis in thirty-seven hours; the 
knives used were rusty, foul and septic. 

Kanohoahu died in thirty-six hours from acute septic periton- 
itis and hemorrhage of the stomach, it was alone possible to staunch 
the subclavian and lung hemorrhage. 

Mahiki recovered in six weeks, his wound was 4 and one-half 
inches deep and cut a large branch of the deep femoral artery. 

On the following Monday, November 2, 1885, the tug "Eleu" 
came to Kalaupapa with the Board of Health and members of 
the Honolulu police force. Lohiau and Momona were arrested, 
deported to Lahaina, tried, convicted, and were sentenced to ten 
years in prison. 

To further add to our cup of misery, the officials of the 
Board of Health and Father Damien received a scolding. 

The priest got into hot water, the doctor also, and Deputy 
Superintendent Hutchison, because we all had wilfully and stu- 
pidly disobeyed the clear (?) instructions of the Board of Health. 
The priest, Hutchison, and myself, heard our denunciations be- 
fore an assembly of lepers at Kalaupapa from the lips of Mr. Gib- 
son, the then president of the Board of Health. 




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82 THE PATH OF THE DESTROYER 

It was also decided to censure R. W. Meyer of Kalae, agent 
of the Board of Health and superintendent of the Leper Settle- 
ment. He was severely crucified in the eyes and ears of the lepers, 
because he had failed to come down into the Settlement and attend 
to the shipping of the orphan girls. 

A few brief words will complete this unfortunate incident. 
The prophets for evil predicted grave disaster, pointing to the fact 
that the Kapiolani Home was baptized in blood, therefore its aims 
and mission would be brought to naught. This has not been real- 
ized, the prophets have long since been gathered to their fathers, 
the home flourishes and accomplishes well the work it was intended 
to do. 

In former years the general dread and, fear that possessed the 
leper when it was proposed to banish him to Molokai, was in the 
main due to statements sent out by the segregated lepers, who 
complained of harsh treatment, no nursing, separation of husband 
and wife, absence of medical attention, poor and insufficient food, 
scanty supply of clothes, difficulty of obtaining rations when sick, 
and a hard, dangerous journey to Waikolu to obtain poi, and many 
other defects of administration, some real, some imaginary. All 
the above combination of complaints, if really believed, were suffi- 
cient to cause a suspect leper to hide himself, and, if he had nerve 
enough, to resist segregation by using firearms. 

Year by year the public lepraphobia is diminishing, and possi- 
bly within ten years a line of policy will be pursued in regard to 
leper segregation, which if in force today, would be regarded as 
rash, revolutionary and fraught with disaster. 

Lepers affected with the infective neuritic form of leprosy 
are a very small menace to the community; it is a secondary form 
of the disease, is more conservative in its attack on the body struc- 
tures than the nodular or primary form of leprosy, the discharge 
from the ulcerating surface tissues and from the carious and nec- 
rosing bones of the hands and feet is devoid of contagious prop- 
erties, because the bacillus leprae is almost invariably absent. This 
same neural type of leprosy could safely have a modified and less 
rigid form of segregation ; the true chief menace and propagator 
of the disease being the nodular form. 

The tendency of leprosy is to become more benign and con- 
servative the longer it exists in a community, its virulence dimin- 
ishes, the type of the disease gradually assumes the neural form, 
and the next step brings about its final extinction. 



CHAPTER VIII. 

EXCERPTS 

From reports of presidents of the Board of Health to the 
Legislature, optimistic and pessimistic, etc. : 

1866 A. D. 
Ferdinand W. Hutchison, President. 
Reports furnished the government by the tax assessors on the 
different islands on the number of alleged lepers. 

Hawaii 75 

Maui, Molokai, Lanai 112 

Oahu 80 

Kauai and Niihau 7 



274 
1868 
Ferdinand W. Hutchison, President. 
To March 31, 1868. — Number of lepers admitted to Kalihi, 
336. 

1870 
Ferdinand W. Hutchison, President. 

"It is believed that there are now FEW lepers not under 
supervision." 

"Dr. Hoffman, physician to Kalihi hospital, reports to me, 
That no NEW cases, genuine or doubtful, have come to his knowl- 
edge during the past SIX months." 

"It may therefore be presumed that the measures used to pre- 
vent the spread of the disease have produced very good results. 
There is good reason to believe there will be a final disappearance 
of the disease if isolation is rigidly enforced for some years. 

"It is the opinion of some that the disease is caused by syphilis, 
others insist that the cause is the use of awa." 

1872 
Ferdinand W. Hutchison, President. 
"Since the last report to the Legislative Assemblv (1870), 
It has been discovered that NUMBERS OF LEPERS were 
SECRETED, especially on the island of Oahu." 

"Reports of medical gentlemen and responsible government 



84 THE PATH OF THE DESTROYER 

officials gave flattering, but as it proved, deceptive information, 
that there were few lepers not under supervision. 

"From the delusive nature of previous information it would 
be perhaps not well to indulge in strong hopes as to the future." 

1874 
Herman A. Widemann, President. 

"After inquiries made in the beginning of the year 1873 it 
was ascertained that at least FOUR hundred confirmed lepers were 
mixing amongst the healthy population." 

"From the beginning of the year 1873 to the present date, 
April 1, 1874, over five hundred confirmed lepers have been sent 
to Molokai." 

1876 
Samuel G. Wilder, President. 

"The Legislature of 1874 made an appropriation of $6,000, 
the expenses of Drs. Powell and Akana 'for Curing Leprosy.' 
These parties were offered every facility to try their skill and 
prove their ability to make good their assertions." 

"Dr. Powell left the islands declining to make any trial. The 
Chinese, Dr. Akana, treated six patients for six months at Kala- 
wao and claimed to have cured ONE, but unfortunately this 
alleged CURED leper was pronounced a confirmed leper by a 
number of physicians, and he was returned to Kalawao." 

"The Board of Health feels assured that leprosy is under 
control and that another TWO years of active action will have 
checked the disease; the Board is confident that the number of 
lepers at Kalawao will from now on DECREASE." 

(Since this optimistic statement was written, 5,536 lepers 
have been sent to Molokai, up to January 1, 1914. — Author.) 

1878 
J. Mott-Smith, President. 
"The Leper Settlement still remains a national necessity." 

1880 
Samuel G. Wilder, President. 
"The office of president of the Board of Health is one of the 
most, if not the most, unpleasant that can be held in this govern- 
ment in its dealings with the leprosy question." 



THE PATH OF THE DESTROYER 85 

1882 
W. N. Armstrong, President. 
"There are probably 2,000 lepers in the Kingdom, or 5% of 
the whole native race. It is probable that as many more have the 
seeds of the disease." 

"In the Kakaako hospital there are 400 lepers, and the num- 
ber is increasing constantly.'' 

1884 
Walter M. Gibson, President. 
"At least 2% of the entire population are affected with leprosy. 
At the Leper Settlement and Kakaako there are treated an average 
yearly of 1,000 lepers." 

"During the past biennial period 777 lepers and suspects have 
been arrested; 90% were cases of several years' duration and 
should have been PREVIOUSLY segregated." 

1886 
Walter M. Gibson, President. 

"We may at length hope that not only has the dread malady 
(leprosy) been checked, and to a great extent controlled, but that 
it is less virulent and malignant in character. I think we are 
justified in taking a hopeful view of the future." 

(Read carefully the following extract taken from pages 46 
and 47 of President Gibson's report, and the connection therewith 
with the leper outlaw Koolau's armed resistance to deportation to 
Molokai is apparent; this happened seven years later, in July, 
1893, in Kalalau Valley, Kauai, which I have already described 
on previous pages.) 

"Hawaiians certainly are beginning to appreciate more and 
more the fact that it is wise that well developed cases of leprosy 
should not live with the clean and healthy, but THEY also feel 
as I do, that the practice of herding all the sick in one place of 
EXILE is a hardship with DOUBTFUL results. 

If segregation can be carried out in ways equally beneficial, 
but more in harmony with the wishes of the people, it should be 
done. 

While it is well for the community that a sufferer from any 
form of contagious disease should leave his home, it is hardly neces- 
sary to compel him to leave his NATIVE ISLAND. 

There would seem to be no valid reason why an experiment 
of 'LOCAL segregation' should not be made on the island of Kauai, 



86 THE PATH OF THE DESTROY ER 

as has been proposed, where a retreat has been selected, and where 
families having a diseased member might place their suffering relative 
and attend to his wants, and be nearer to him than if 'doomed' to 
Molokai. 

The government would be willing to provide any reasonable 
measure of relief as well as to furnish medicines. Where a com- 
munity is found willing to voluntarily segregate its own sick and 
to care for them, why should a government be called upon to ex- 
pend large sums for a plan of segregation which can never be 
thoroughly carried out, bearing in mind the occult and mysterious 
nature of the disease in its long term of incubation and de- 
velopment?" 




GEORGE TROUSSEAU, M. D., PARIS. 

President of the Board of Health; a model executive. One of the few, 
poor man's president. "Suaviter in modo, fortiter in re." 
Died Mav 4, 1894. 



PART II. 



AGENTS ALLEGED TO CAUSE THE SPREAD 
OF LEPROSY 



VACCINATION. 

MOSQUITOES. 

FLIES, FLEAS, BED-BUGS. 

THE LEPER BREATH. 

LEPER BACILLI EXTERNAL TO THE LEPER. 

CARRIERS OF LEPROSY. 

AWA. 

SALT FISH, SALT. 

POL 

PEDICULI, SARCOPTES HOMINIS. 



Throughout this monograph the word "NODULAR" lep- 
rosy is made use of in place of the word "TUBERCULAR'' 
leprosy, for this latter is misleading to persons unfamiliar with 
medical terms, and may lead to the assumption that Tubercular lep- 
rosy is connected with Tuberculosis. 

Neural leprosy, or that form of the disease which affects the 
nerves, is more appropriate than Anaesthetic leprosy, which is 
merely one symptom, and present in all forms of leprosy. 

Mixed, or Dual leprosy is a form in which certain features of 
the Nodular and the Neural type are combined. 



CHAPTER I. 

VACCINATION 

There is in Hawaii a widespread feeling of dread and re- 
pugnance to the performance of vaccination. The vaccinophobia 
had its origin at or about the time of the first small-pox epidemic, 
May, 1853, when thousands of the Hawaiian race were carried 
off by this epidemic. In order to check the ravages of the dis- 
ease arm to arm vaccination became a general practice, in the 
main due to shortage in the supply of bovine and calf lymph. 

Sixty years ago asepticism was unknown and vaccination was 
performed indiscriminately by any one willing to perform the 
operation. Each amateur vaccinator acted as he thought best, 
which meant septic lancets and pus taken from the pustule of the 
donor, or lymph, if perchance obtained. To the ignorant operator 
both of these media would serve the purpose, the man, woman 
or child, whichever it might be, was vaccinated. Penknives were 
in use when no other lancet or scarifier could be had. It is there- 
fore not surprising that deep ulceration at the seat of operation, 
erysipelas and pyoemia were common results of vaccination, which 
speedily brought the operation into ill-repute. What must physi- 
cians of today think of the following extract taken from the rec- 
ords of the Board of Health? A respected physician, now resident 
on the islands, was informed that "the usual price of 25 cents for 
each successful vaccination was to be reduced to 12^2 cents, as 
some physicians here in Honolulu had vaccinated persons for that 
sum, and one of them 2,500 for a stipulated sum of $75, or 3 
cents apiece, and provided the vaccine virus!" 

Furthermore, in the years 1880-81 small-pox was introduced 
into Honolulu from San Francisco, and caused the death of 252 
persons. Vaccination and re-vaccination was resorted to and many 
reliable foreigners have told me that as soon as the operation was 
performed the party vaccinated was thereafter as soon as con- 
venient, subjected to suction of the wound by the parent's mouth, 
or other person, in order to avoid the germs of leprosy! 

When I came to Hawaii in the spring of the year 1883, I 
soon became aware that even many medical men attributed the 
unusually rapid spread of leprosy in Hawaii to inoculation by 
careless and incompetent vaccinators, chiefly laymen. Even one 
or two doctors, during the small-pox scare, admitted taking the 



94 THE PATH OF THE DESTROYER 

lymph from arm to arm, without disinfecting the lancet or scari- 
fier before vaccinating each person. 

In those early years of my residence in Hawaii I accepted 
the possibility of vaccination being a very probable and feasible 
cause of spreading leprosy, but more mature experience has con- 
vinced me that vaccination gets more credit, than it deserves, and 
cannot spread the disease, FOR LEPROSY CANNOT BE IN- 
OCULATED BY ORDINARY MEANS ON A DERMAL 
SURFACE. 

It. has also been held by certain physicians that leprosy can 
be inoculated through vaccination — the vaccine running its regu- 
lar course in the system and leaving the bacillus leprae "latent" in 
the scar. I cannot accept this without more proof, for as a matter 
of fact, the scar of vaccination, plus alleged subsequent develop- 
ment of leprosy, presents not a particle of difference in its ap- 
pearance from that, of the adjacent skin, than does the scar on the 
arm of a healthy person. 

In the year 1887, 62% of the lepers on Molokai showed no 
scar or mark indicating vaccination. 

Where leprosy has invaded certain white and Caucasian- 
Hawaiian families, and it was believed that vaccination was the 
attributive cause of the breaking out of the disease, on careful 
investigation, I found there had been leper contacts with the in- 
fected members of these families, as everywhere. The Hawaiians 
freely admit leper relatives, but amongst foreigners to admit a 
leper family tree is a rare occurrence. In Hawaii today, if a 
foreigner develops leprosy it is only too frequently put down to 
"immoral acts and illicit sexual liasons with some wahine Kanaka." 
The injustice displayed by attributing sexual acts as a cause of 
infecting a healthy person with leprosy is apparent, when it is 
considered that a large number of persons living in conjugal re- 
lation, sometimes the husband a leper, sometimes the wife, fail to 
contract the disease, and also children of early years, six to ten, 
frequently are lepers. In the face of the fact that I know of 
nearly 100 cases where deliberate inoculation with leprous blood 
serum has failed to convey leprosy to the inoculated person, it 
must be a very rare event when vaccination causes the spread of 
the disease. No one would deliberately use a leper as a source of 
vaccine lymph. Today all our vaccine lymph is imported, and 
guaranteed to be pure calf lymph. 



THE PATH OF THE DESTROYER 95 

Vaccination, no matter how carelessly the operation is per- 
formed, would spread leprosy amongst All races alike if it was a 
cause of spreading the disease. The foreigners are more efficiently 
vaccinated than the Hawaiians, who, as I have stated before, 
showed 62% absence of vaccination scars at the Settlement — a 
very large percentage; yet the foreigners, Caucasians and Asiatics, 
are very little affected with leprosy. Vaccination is more thor- 
oughly carried out amongst them (foreigners) than amongst the 
Hawaiians, who ought to be less affected with leprosy, owing to 
non-vaccination, whereas, in fact they suffer more severely from that 
disease. 

From all the foregoing statements, vaccination cannot be ac- 
cepted as a factor in spreading leprosy in Hawaii. In Europe 
the great spread of leprosy occurred 600 years before Edward 
Jenner (1749-1823) discovered vaccination. 

MOSQUITOES 

The mosquito was unknown in Hawaii previous to the com- 
ing of foreign ships. 

In the year 1826 a vessel from Mazatlan, Mexico, at anchor 
off Lahaina, Maui, is credited with introducing mosquitoes into 
Hawaii. The fumigation of this ship drove the mosquitoes out of 
the hold of the vessel, and the story says, "they came ashore in 
clouds;" today, these islands afford a home to many varieties of 
mosquitoes, some localities being more affected with "the pest" than 
others. What species of mosquito was brought in this ship from 
Mexico is doubtful; from the information I have been able to 
glean it was possibly the night mosquito, Culex pipiens, the break- 
bone fever carrier. The day mosquito, two varieties, are prevalent 
in the islands, one, the Stegomyia Fasciata or Calopus, which 
transmits yellow fever to man, is widespread ; but we have no 
yellow fever in Hawaii. That fever is peculiar to the West In- 
dies and its original habitat was there. The opening of the 
Panama Canal makes the prospect of Hawaii being infected with 
yellow fever a lurking danger. 

Although mosquitoes were brought to Hawaii, as before 
stated, in the year 1826 (the Hawaiians have no word for mos- 
quito in their language, but borrow the foreign word and use a 
Hawaiian pronunciation), it was some twenty-five years after 
their introduction that mosquito nets came into use, sometime in 
the early fifties. 

The late Mrs. U. S. Emerson of Waialua, Oahu, the wife 



96 THE PATH OF THE DESTROYER 

of one of the missionaries of the American Board of Missions, in- 
formed me that it was in the late fifties, 1858 or 1859, that the 
night mosquitoes first became a pest, and the use of nets had to be 
resorted to in order to obtain sleep from the annoyance of the 
insect. I found Waialua more infested with mosquitoes than any 
other locality on the island of Oahu. 

The Hawaiian, if not provided with a mosquito net, covers 
his head with the blanket to avoid being bitten by the mosquito. 
This is a most pernicious practice, with closed windows and doors, 
the air supplied under the blanket is impure, and is rebreathed 
again and again, is naturally injurious to health and damaging 
to the air cells, and it, is also a predisposing cause of tuberculosis, 
now quite active and widespread in Hawaii. 

Whether it be mosquito netting, or blanket protecting the 
sleeper from the mosquito, it is evident that the alleged spreading 
of leprosy by mosquitoes must affect all races alike, and here comes 
the stumbling block. Is the Hawaiian more subject to leprosy 
on account of being more exposed to mosquito bites than the 
foreign races domiciled in Hawaii? 

NO — all races are equally exposed and should develop lep- 
rosy pro rata, if the mosquito spread the disease. I assert that 
the mosquito may be ignored as an active factor in spreading 
leprosy in Hawaii, and to back up this assertion I offer the fol- 
lowing experimental work. 

Mosquitoes of both the day and night species, found inside 
the mosquito nets of lepers and gorged with blood, were examined 
with greatest care — the blood in the insect's stomach, its saliva and 
the whole of the body were carefully triturated in a mortar. 

Twenty-eight mosquitoes from different leper beds were ex- 
amined, twenty of these beds being occupied by confirmed nodular 
or tubercular lepers. In no single instance was Hansen's leper 
bacillus observed. In the remaining eight cases of nerve leprosy 
the mosquitoes collected and examined gave also in all cases negative 
results — no bacillus leprae could be found. A total of sixty-six 
other mosquitoes were also examined, which infested leper houses, 
four of the lepers being affected with the Recurrent leprous fever. 
At such times the bacilli are said to be present in the blood in 
large numbers, but the mosquito in its contact with the leper's skin 
and blood had carried away no bacilli in any single instance. 

Another point, the mosquito selects by preference the healthy 
skin of the leper, avoiding tubercles, scars, atrophied dermal patches 




HAWAIIAN TYPE. 
Pure Hawaiian. 



98 THE PATH OF THE DESTROYER 

and dense infiltrations; when no other site is available then alone 
the unhealthy skin is selected. 

Mosquitoes do not confine their unwelcome attentions to any 
one race, as I stated before. If the Hawaiian race were, and if 
it could be proved they were, more mosquito bitten than any other 
race, then the mosquitoes' work in inoculating the healthy person, 
(after sucking the bacillus leprae into its stomach and salivary 
glands), might be a factor in spreading leprosy, if it, within a 
reasonable time, found a healthy person to bite. Other experiments 
with the object of demonstrating and clearing up the part, if any, 
mosquito inoculation plays in the spread of leprosy, were carried on. 

Mosquito cages containing single, two, and four mosquitoes or 
both the day and night varieties were affixed to the skin of twenty 
male lepers and ten female. Parts chosen were neck, arm, face, 
calf and abdomen. The cages were arranged to take in both 
healthy skin and leper infiltrations, small tubercles with surround- 
ing healthy skin, and anaesthetic patches, the insects being left in 
contact with the skin from thirty minutes to six hours. 

These experiments were carried on at various periods over 
a term of years. Out of fifty-two previously starved and attenuated 
mosquitoes, thirty-five insects had fed on the leper, and were tor- 
pid and gorged with blood. Seventeen mosquitoes contained no 
blood. The same peculiar selection of healthy skin by the mos- 
quito became apparent in twenty-two cases, the remaining thirteen 
insects, possibly because of hunger, sucked blood from the diseased 
patches of skin. 

The most careful search was made for bacilli, but they could 
not be found. The Haustorium of the mosquito in forty other 
instances yielded no bacilli, after drawing leper blood. 

If the mosquito spreads leprosy, we would have more lepers, 
and leprosy would not be confined to one race, is my conclusion. 

From all this evidence, it is reasonable to assume that the 
mosquito of any species as a spreader of leprosy may be ignored, 
even if the bacillus leprae was found in the insect. 

FLIES 

The same arguments may be used against flies being a cause 
of the spread of leprosy, that have been used in connection with 
the alleged spread of leprosy by mosquitoes. 

To reiterate again and again, the Hawaiian race is most 
severely affected with leprosy. 

Their houses and surroundings have no more flies than the 



THE PATH OF THE DESTROY ER . 99 

same conditions prevalent around the houses of Porto Ricans, Fili- 
pinos, Negroes, Koreans, Japanese, Chinese, etc., and all other 
races in Hawaii. 

The Hawaiian house has no monopoly of flies. In fact, it has 
less flies than the houses of the above peoples, who are always 
cooking and throwing refuse food alongside their dwellings, which 
attracts the flies. This statement applies to the lower strata of 
all the above enumerated races. 

If the house fly confined its presence chiefly to the Hawaiian 
house, and the houses of other races were practically free from flies, 
I might entertain a spread of leprosy by the infection of the food 
of the non-leper with bacilli from open sores of the body or the 
sputum of the leper. Of course it is plain that flies, in the pres- 
ence of a leper with open sores, might be a source of infection to 
the food of non-leper companions in the same house, or the flies 
might possibly infect any abraded dermal surface of the exposed 
parts of the body of the companions of the leper, be they wife, 
husband, child, friend, as the case may be, but / will not even 
admit that a fly can enact this role in the spread of leprosy. 

There is abundant evidence to prove that leprosy is not in- 
oculable by ordinary methods (if it is inoculable at all). The 
bacilli are not per se permanent inhabitants of the blood, excepting 
in the bacillemia of leprous fever. 

Let us turn to syphilis and tuberculosis, both chronic infective 
diseases, and both well proven to be inoculable. What physician 
can maintain that the house fly is the sole cause of the spread of 
syphilis or tuberculosis? Can it be proven positively in any given 
case that the fly is responsible? As to syphilis, direct inoculation by 
the fly on the skin (abraded if you like), of a non-syphilitic is 
such an impossibility that no case has even been recorded, yet we 
know syphilis is easily inoculable and yet we do not claim that 
the fly spreads syphilis by inoculation. 

Leprosy may possibly be spread by flies contaminating or in- 
oculating the skin of healthy persons, although there is no direct 
proof that leprosy is inoculable. What is not claimed for an in- 
oculable disease like syphilis, we do claim for a non-inoculable 
disease like leprosy. Is not this position unreasonable? 

I cannot accept the fly as a material factor in the spread of 
leprosy; all races are equally exposed to fly contamination. The 
Hawaiian not specially so. The lepers segregated on Molokai 
originally came out of the general population of all the races — a 
leper here, and a leper there. Is it unreasonable to conclude that 



100 THE PATH OF THE DESTROYER 

the greater the number of people (foreigners) in our population 
must mean greater fly contact, and hence greater exposure; and 
the smaller the number of people (Hawaiians) the less the con- 
tact and the less exposure to contagion by fly infection? 

Bear in mind the figures of 1900 census. 

Foreigners, 76% of the total population, with a total of 63 
lepers. 

Hawaiians, 24% of the total population, with a total of 964 
lepers. 

More people of any race means more possibilities of fly in- 
fection, hence more lepers, and vice versa, less people, less infec- 
tion by the fly, less leprosy. Whereas the exact opposite condition 
prevails. The Hawaiian people being in the minority, should be 
less exposed to fly infection, yet they have a preponderance of 
leprosy. 

If all races were equally affected with leprosy in Hawaii, the 
possibility of the house fly conveying the disease would receive 
greater credence. 

Leper recruits would come from the ranks of all races if the 
fly was a specific spreader. Leprosy's remarkable predilection for 
the Hawaiian people cannot be attributed to 'the house fly. 

In order to throw more light on the claim that the house fly 
is a source of infecting man with leprosy, then let us go further 
afield from Hawaii, and look at the aspect of this mooted question 
in the knowledge we have acquired of the disease in Europe. The 
continued presence and prevalence of the fly still remains in 
Europe, and in the summer is just as much an annoyance and 
nuisance, and a spreader of certain diseases on that continent as it 
is in the United States of America, but leprosy almost disappeared 
in Europe, although the house fly still existed and controlled the 
situation as a spreader, or alleged spreader, of that disease. 

No evidence is brought forward to show that measures cal- 
culated to diminish or exterminate the fly were ever carried out. 

To accept the fly as a possible ever-day menace of the com- 
municability of leprosy, we are led to conclude that coincidentaily 
with the disappearing disease, the infection should have continued 
in the same ratio of cause and effect as long as the fly existed, but 
the inference must be drawn, and may be summed up in the state- 
ment: leprosy disappears, the cause of its spread (the fly) remains. 

The effect is a proved fact, but the cause is not a proved fact. 
A cause or alleged cause of any disease still existing, and the di>- 



THE PATH OF THE DESTROYER 101 

ease disappearing, it cannot be truly claimed that the cause or 
alleged cause of the disease was the true cause. 

I have examined hundreds of flies and never once succeeded 
in finding the leper bacillus, although bacillus tuberculosis was fre- 
quently found. 

Some more specific cause and peculiar to the Hawaiian race 
must be sought for, in order to explain the greater prevalence of 
leprosy amongst that race. The house fly fails to fill the bill. I 
claim in the face of all the foregoing statements, the house fly may 
be excluded as a spreader of leprosy- 

FLEAS AND BED-BUGS 

These insects are generally permanent occupants of houses 
and rooms; they do not travel around like mosquitoes and flies. 

If there is to be any infection with leprosy in any given house 
by fleas or bed-bugs, it presupposes a leper occupant of the house 
and non-leper companions. 

Both these insects are parasites infecting the human race, 
and derive their nourishment from the blood of the victim who 
carries them on his or her person, clothes, or bedding. 

There cannot be a supposed universal spread of leprosy through 
these insects, because every house does not contain a leper. 

Having examined fleas and bed-bugs from leper houses and 
failing to find any bacillus leprae, I question if these insects can 
convey leprosy to a non-leper; they are purely blood suckers, and 
the blood of the leper is not a permanent habitat for the bacillus 
leprae. 

EXPERIMENTS ON LEPERS 

I have fastened both fleas and bed-bugs, in small impromptu 
cages made out of corn plasters, the cover of a microscopic slide 
affixed to the opening, and strapped the cage to the inner surface 
of arms, thighs, and sides of abdomen, both on leprous lesions and 
healthy skin of lepers; the insects being allowed many hours 
to feed — from one to four hours. On thorough examination, no 
leper bacilli were discovered, either in the expressed blood from 
the insects' digestive tract, or in the insects' body, triturated with 
alcohol and the solution centrifuged. 

Discussing the possibility of a healthy person being infected 
with leprosy by the bites of fleas and bed-bugs, subsequent to these 
insects having bitten a leper, I take the same ground as I have 
done in the alleged fly and mosquito propagation or spread of leprosy. 



102 THE PATH OF THE DESTROYER 

The Hawaiian race has no monopoly of fleas, nor are its mem- 
bers infested with a preponderance of fleas and bed-bugs in their 
homes, yet they have excess of lepers; these insects infest all races 
alike, and each race should show a percentage of leprosy propor- 
tionate to its number. 

The greater the number of people, the larger the field foi 
the fleas and bed-bugs to spread leprosy. The smaller the number 
of people, the smaller the field for the fleas and bed-bugs to infect 
with leprosy. 

More fleas and bed-bugs biting the people, more lepers. Less 
fleas and bed-bugs biting the people,- less lepers. 

Thanks to the multitude of races in Hawaii, we can tenta- 
tively approximate the most probable cause of disease in any one 
race. Amongst all the previous alleged reasons for the cause of 
the spread of leprosy I have discussed, viz. : vaccination, mosqui- 
toes, fleas and bed-bugs, under each of these factors common to all 
races, the Hawaiian race is always paramount as the exponent of 
leprosy. A more specific and peculiar property attaching to the 
Hawaiian race must be sought for than insect infection, to which 
all races undergo similar exposure. The flea by preference seeks 
the healthy skin to get his blood supply for food. The bed-bug 
sucks blood from any surface, healthy or diseased, apparently dis- 
playing no preference. 

Those who are in attendance daily on lepers in homes and 
hospitals, like doctors, the Brothers and Sisters of Mercy, and 
other attendants, are fully exposed and are, and must be bitten by 
fleas (I have had ample personal experience on this point), but 
after 10, 20, 30 years even, no development of leprosy has taken 
place amongst these people. 

How often can we determine in a given case of syphilis or 
tuberculosis, the exact means of infection. If we are in doubt 
would we seek a flea or bed-bug explanation as the means of in- 
fection? We would be justified in so doing, knowing that syphilis 
and tuberculosis are inoculable; but we do not assume that hypo- 
thesis. Why not analyze the means of leprosy infection on a 
broad basis? We have a disease which is prevalent mainly in one 
race. Why is this? How does this race differ in every respect 
from the others? I will discuss this later. 

From all the foregoing experiments and statements there is 
every reason to assume that fleas and bed-bugs, as agents in the 
spread of leprosy, may be ignored. 



THE PATH OF THE DESTROYER 103 

DOES THE BREATH OF A LEPER CONVEY THE 

DISEASE? 

All the evidence bearing on this question tends to prove that 
the breath of the leper, even if the contact is close, does not con- 
vey leprosy to a healthy person. 

The attendants on lepers — nurses, Brothers and Sisters of 
Mercy; in fact, all those in direct contact with the disease, rarely 
acquire it. There are no figures to show in an asylum or settle- 
ment, that even 1/20 of \ r / c of the above class of contacts ever 
acquire the disease from inhalation or even any similar channel. 

No more striking testimony can be produced than that afforded 
by the conjugal relation. 

The leper wife, or the leper husband, occasionally conveys 
the disease to his or her healthy consort, they may live together co- 
habitating for years and yet the healthy wife or husband may or 
may not become infected. 

What a different disease leprosy is from syphilis in this re- 
espect — the aspect of cohabitation — here syphilitic infection of a 
healthy partner is generally a foregone conclusion. 

Syphilis is not conveyed by the breath, and even in tubercu- 
losis conjugal infection is uncertain, but the method of infection 
in these two diseases does give a clue to the way leprosy is con- 
veyed. 

If leprosy was conveyed by the leper's breath we would have 
more prevalence of leprosy amongst all races, not, as here in Ha- 
waii, a one-race disease — Hawaiians. 

I append a table bearing on Conjugal infection and Non-infec- 
tion with leprosy. 

STATISTICS DATING FROM YEAR 1880 TO YEAR 1902 
Male and female lepers living in the Conjugal relation. 

1. Place of collection, segregated on Molokai 845 

2. Place of collection, in detention at Kakaako 191 

3. Place of collection, various islands of group 64 

Total 1,100 

Male lepers 739 Male non-lepers 361 

Female lepers 361 Female non-lepers 739 

Total 1,100 Total 1,100 
Total of persons living in conjugal relation 2,200 



104 THE PATH OF THE DESTROYER 

Maximum years of cohabitation 18 

Minimum years of cohabitation 8 

Average years of cohabitation 13 

Husbands who became lepers — 101 

Husbands who did not become lepers.— 260 

Wives who became lepers 159 

Wives who did not become lepers 580 

Of the husbands, 101, who became lepers, — 84 of their wives had 
Nodular leprosy; and seventeen Neural leprosy. 

Of the wives, 159, who became lepers, — 136 of their husbands had 
Nodular leprosy; and twenty-three Neural leprosy. 

In an original total of 1,100 clean husbands and wives, 260 
(23%%) became infected, and 840 (76%%') remained clean, after 
an average of thirteen years of cohabitation. 

Did these 260 previously clean husbands and wives acquire 
leprosy by the breath or through sexual intercourse? I answer: by 
neither of these channels does the specific infective agent, the bacil- 
lus leprae, enter the system. 

Digressing a little from the subject of infection from the 
breath of the leper. 

The lepers give birth to many children, most of them succumb- 
ing soon after birth — some are born dead, or abortion takes place. 
I have seen over 200 children, the offspring of lepers, sometimes 
both parents were lepers. In no single instance were there any 
signs of leprosy on the children at birth. If we did not know 
syphilis was inoculable, we quite as likely might assume it was 
spread by the breath ; the presence of syphilis is generally in evi- 
dence at. the birth of a child of syphilitic parent or parents. 

In later years the child of the leper may show the disease, 
and we might too hastily assume that infection from the leper 
parent or parents was conveyed to the child at the time of con- 
ception. This theory is untenable. The child of the leper is like 
the child of the tubercular parent — the infection is acquired post 
natal. 

Hereditary predisposition in leprosy is becoming a waning doc- 
trine. It is obsolete. I used to be one of its disciples; more 
mature experience has convinced me of the fallacy of my position. 

In tuberculosis, a well-known contagious disease (through spu- 
tum, etc., and being inoculable), the majority of those who have 




HAWAIIAN TYPE. 

Pure Hawaiian Girl. 



106 



THE PATH OF THE DESTROYER 



been exposed to infection through conjugal relation escape the 
disease. 

We may safely conclude that the breath of the leper is similar 
to the BREATH of the syphilitic, and that it is devoid of in- 
fective properties. 

THE BIRTH RATE AMONG LEPERS 

Sterility in former years was more in evidence amongst the 
lepers than it is today. 

Formerly most of the cases of leprosy when sent to Molokai 
were of long standing, five to seven years or more, and some over 
the latter limit. Of necessity the longer duration of the disease 
sapped the vitality, and the fertility of the leper was impaired or 
lost entirely. 

The segregated leper today arrives at Molokai with a milder 
and much shorter duration of the disease than formerly, averaging 
about one to three years standing. 

The leper birth rate is very little below that of the non- 
leper rate, or normal, but premature births and lack of vitality 
cause most of the children, the offspring of a leper parent or par- 
ents, to succumb at or shortly after birth. 

It is most remarkable that the children of lepers who reach 
maturity are free from defects of mind and body. Neither morons 
nor imbeciles are found, and nanism in any form is absent. 

I append an analysis of the birth rate amongst one hundred 
and seventy leper couples. 

Fertile Sterile 



93 Couples 



1 

Male, 

Leper 

62 


1 

1 

1 


1 
Female, 
Non-Leper 

62 


1 
Male, 
:>n- Leper 
31 
Childre 
3 


n 
85 


1 

Female, 

Leper 

31 

Born 



77 Couples 



Male, 

Leper 

51 



Female, 

Non-Leper 

51 



Male, Non-Leper Female, Leper 
26 26 



I .1 

Children Living Children Dead 

168 217 



THE PATH OF THE DESTROYER 107 

EXPERIMENTS ON THE LEPER'S BREATH 

In order to satisfy myself if the breath of the leper was a 
possible means of spreading leprosy, I experimented as follows: 

Twelve-inch squares of double folds of antiseptic gauze were 
suspended over the faces of lepers at distances by actual measure- 
ment of 12, 6, 3, and 1 inches from the mouth, for periods of half 
an hour to three hours, and in two instances in comatose lepers for 
a 12-hour period; cases were selected free from cough, tranquil 
ordinary breathing being present. 

This experiment was performed on twenty lepers. The gauze, 
after exposure to the leper's breath was carefully soaked in 5% 
carbolized water, as little fluid being used as possible; after stand- 
ing six hours the washings from the gauze were centrifuged, care- 
fully examined and search made for bacillus leprae — none were 
discovered. 

On five other lepers — two advanced tubercular cases, one mild 
case, and two of the neural form of leprosy — a similar set of ex- 
periments were carried on with gauze squares on the same lines as 
in the preceding cases, excepting that the leper was instructed to 
breathe deeply and cough, but not expel mucus from the mouth, 
the squares of gauze being held in CONTACT with the mouth and 
nose for a period of five minutes. The gauze, after contact, was 
soaked for six hours in a limited quantity of distilled water, the 
washings centifuged and carefully examined. Bacilli were found 
in limited quantity in the two advanced tubercular cases. In the 
mild case and the two neural, the washings from the gauze failed 
to show bacilli. 

Mosquito nets surrounding the beds of six tubercular (or 
nodular) cases of leprosy in advanced stages of the disease, the 
nets not having been laundried for a period of many months, were 
soaked for six hours in a limited quantity of distilled water, the 
washings carefully examined for bacilli — all six washings gave 
negative results. 

All this evidence tends to show that if the bacillus leprae 
exists outside the human body, it must be of very rare occurrence, 
except in the direct presence of the leper. Tables, chairs, and the 
dust of the rooms in daily use by lepers gave negative results; in 
no instance were bacilli found, although other observers claim they 
do exist. The British Indian Commission of 1891 reached the same 
results that I have done, finding no bacilli on the seats, walks, or in 
the bathing houses of the lepers. It is a well-established fact that 



108 THE PATH OF THE DESTROYER 

syphilis is never conveyed by the breath, the specific infective ma- 
terial, syphilis bacillus, must be implanted direct on a mucous, or 
abraded dermal surface in order to convey the disease. 

The foregoing experimental evidence tends to prove that the 
bacillus leprae, to infect the healthy, must also be implanted on a 
mucous surface, which surface must possess certain suitable specific 
properties. 

It is very probable that the leprous bacilli in contact with the 
air after passing through the nose and mouth are cadaveric bacilli, 
and as such, are incapable of spreading leprosy. 

The evidence afforded from the prevalence of leprosy in Ha- 
waii amongst the foreign races, also tends to negative the possibility 
of leprosy being spread by the breath of the leper. 

Out of an estimated foreign population of 160,000 in the year 
1912 there were only 105 known lepers, which may be accepted as 
a fairly correct estimate. 

So much contagious and infectious disease is communicated by 
the breath, it is fair to assume that if leprosy was so communicated, 
it must affect all races equally. Pulmonary tuberculosis (a dry 
sputum and a breath-infection spread disease under certain special 
conditions), in this present year, 1915, selects no special race, but 
finds in Hawaii its victims amongst all races. It attacks the Jap- 
anese, Portuguese, and the Hawaiians, also other races, and it is a 
worse scourge than leprosy. 

It may also reasonably be deduced that if pulmonary infec- 
tion through inhalation of the leper's breath, was one of the causes 
leading to the infection of those in contact with leprosy, it would 
not be confined to one race in Hawaii (the Hawaiians), but each 
race would show a more equal infection ratio ; also the disease 
would be much more prevalent. 

I assume the same ground as in other alleged causes of leprosy 
previously discussed. More people to inhale the breath of lepers 
means more leprosy; hence the more numerous the people of any 
one race, the greater should be the number of lepers, and vice 
versa, less people, less leprosy. 



LEPROUS TUBERCULOSIS 

Leprosy first infects its victim and is often followed by tuber- 
culosis; but how often does a tuberculosis victim acquire leprosy? 
I know of few such cases. 

Both leprosy and tuberculosis will thrive in the same lung, 



THE PATH OF THE DESTROYER 109 

but the dry sputum from the leper's lung shows no virulent in- 
fective power like the dry sputum of the tubercular subject. 

Lepers react strongly to injections of tuberculin, just as se- 
vere as if their disease was tuberculosis; this reaction is due to 
deposits (tubercular) in the organs, glands, and other tissues of the 
leper. 

The complication of leprosy with tuberculosis is very frequent; 
these cases may fairly be termed ones of leprous-tuberculosis, leprosy 
being the primary disease. 

At certain intervals the typical symptoms of leprosy prevail 
and progress, then come remissions, the leprous symptoms remain 
in abeyance, later T. B. comes to the fore as the aggressor and 
destroys the leper. 

The destruction of the epiglottis, the stenosis of the larynx, 
the visceral deposits, intestinal and stomach derangements in the 
leper are just as frequently caused by T. B. as leprosy. 

The physician may cause certain symptoms of leprosy to im- 
prove by suitable treatment, but when the disease is complicated by 
the presence of T. B., the futility of expecting any beneficial result 
from any treatment soon becomes apparent. 

The presence or non-presence of tuberculosis in the leper will 
generally account for the rapid or slow progress of the disease. 

LEPER BACILLI EXTERNAL TO THE LEPER 

Do leprous bacilli exist outside the person of a leper? I answer 
in the affirmative, in the leper toilets, in the leper s grave, and 
in the various articles of food and drink which he touches and 
handles. 

The intestines of the leper, when his disease is advanced, con- 
tain the bacillus leprae in large numbers, hence the dejecta act 
as a vehicle of expulsion. 

In leprous diarrhoea and dysentery, due to destruction and 
ulceration of the mucous membrane of the ileum and large in- 
testine, the shreds of exfoliated mucosae contain the bacilli which 
are expelled with the movements of the bowels. 

Faeces and mucus collected from the seat of the leper's toilet 
contain abundance of leper bacilli. 

The leper ulcer of the bowels is closely allied to and resem- 
bles the tubercular ulcer. The solitary and Peyers glands are in 
the main implicated, hence the ulcers are observed in the ileum; 
frequently the caecum and colon are involved, the morbid changes 
being confined to these localities. 



110 THE PATH OF THE DESTROY ER 

The ulcers are irregular in shape, situated transversely to the 
mesentery. The spread of the ulcer, following the course of the 
vessels, involving at times the whole circumference of the bowel. 

In size the ulcers vary from one-half to one inch or more, 
with thickened edges, at times markedly indurated. The floor ot 
the ulcer often shows signs of recent hemorrhages, at times new 
cicatrization processes are in progress. (See Plate 73, Ulcers of 
the Ileum.) 

I have examined the graves of three lepers. All the corpses 
had been buried over two years — exact dates unknown — the soft 
parts of the bodies had all been dissipated. 

The liquid and a semi-pulpy material in the coffins yielded 
plenty of bacilli ; but are the bacilli alive ? I claim they are not. 
From the evidence afforded that leprosy is not pathogenic to ani- 
mals, there is further corroboration. 

These bacilli are within every reasonable doubt cadaveric. It 
is scarcely within the bounds of probability that any person could 
become infected with leprosy from either the toilet or the grave 
of a leper, under any circumstances. 

In the month of May of the year 1885, Dr. Edward Arning, 
pathologist and bacteriologist for the Board of Health, and special 
leprosy investigator, visited the Leper Settlement in the course of 
his studies. The doctor being desirous of examining a recently 
buried leper corpse, I showed him the grave of Akana, a Chinese 
leper, buried about six months, on a hillside, the surroundings and 
soil being good for drainage. To avoid wounding the feelings of 
the Hawaiian people, who have an aversion to desecration of the 
graves of their friends, like ourselves, even for the advancement 
of science, the corpse of the Chinaman was chosen for exhumation. 

However, a mistake was made and when the coffin was opened 
and the corpse came into view, no queue was visible, it was not 
the body of Akana, the Chinese, but that of Keliikipi, a Hawaiian 
about twenty-eight years of age, affected with nodular leprosy. 
This man poisoned himself with opium (cause unknown), his 
corpse had only been interred three months, but it suited Dr. 
Arning and he later obtained abundance of bacilli from the de- 
composing tissues of this corpse. 

Examinations of buried lepers' corpses clearly demonstrate 
that the bacilli resist the products of dissolution and putrefaction. 
Are they alive? I have stated before, I doubt if these bacilli could 
infect a healthy person, as they are most probably cadaveric. Dr. 
Arning was in doubt on this same question, but unfortunately be- 



THE PATH OF THE DESTROYER HI 

fore completing his investigations on this point, he resigned his 
position as leprosy investigator for the Board of Health and returned 
to Germany. 

Other investigators came after Dr. Arning, holding official 
positions with the Board of Health, but sooner or later the re- 
lations between the doctors and the Board became strained, and 
one after the other have left office on account of various troubles. 

Dr. Arning pursued his investigations from November, 1883, 
to December, 1885. After him came Dr. Lutz, in the year 1889; 
he worked about two years as leprologist for the Board of Health, 
then w T ent to San Paulo, Brazil. 

About the year 1896, Dr. Alvarez was appointed to office as 
pathologist to the Board of Health, and held office some three 
years, till 1899. In the year 1909, Dr. Wayson, a resident of 
the islands for about fourteen years, took charge of the Kalihi Re- 
ceiving Station and held office until April, 1914, when some un- 
pleasantness with the Board of Health caused him to resign his 
office. 

The many drawbacks, hindrances, and petty tyrannies dis- 
played towards leprologists, have not tended to advance the esteem 
or enthusiasm of the outer world physicians towards the scientific 
study of leprosy in Hawaii. 

ARE THERE CARRIERS OF LEPROSY? 

On this point I put forward certain facts I have discovered 
in my thirty-three years of professional practice in Hawaii, and in 
reply to the above I answer that there are carriers of leprosy. They 
are very exceptional, however, and their presence at large in the 
population I claim is no factor in spreading leprosy. 

First, there are cases of leprosy that manifest in the skin and 
nerves all the signs of leprosy, and the bacillus leprae may or may 
not be present. Without any treatment or special change in the 
conditions of their living, eating, or occupation, the disease dis- 
appears for months and years, sometimes becomes active again, 
making no further progress than it did at the first onset. These 
cases puzzle the doctors, but not the laity, who affirm, "these peo- 
ple never had leprosy, the doctors have failed to make a correct 
diagnosis, the disease must have been blood poisoning, syphilis, 
eczema, or something else; those stupid doctors ought to be sued 
for damages!" 

I especially call to mind five cases which first came to my no- 



112 THE PATH OF THE DESTROYER 

tice over twenty years ago. These cases showed pronounced signs 
of leprosy, and had been declared leprosy by competent physicians. 

The official examining board being then composed of three 
medical men, the agreement in diagnosis was unanimous — "Con- 
firmed Lepers." 

Four of the five cases were ordered deported to Molokai. 
There came some hitch and these lepers (?) never left Honolulu. 
Three of the cases are alive today, their leprosy is not progressive, 
and the friends of the people loudly affirm that they never had 
the leprosy. I saw every one of these five lepers, or alleged lepers, 
and treated two of them, and these said two cases claim that if 
they did have the leprosy I cured them — a very vague and dubious 
compliment. I regard these cases as permanent carriers of leprosy. 
The disease has apparently aborted, but it would be impossible to 
say in the present state of our knowledge, whether they can com- 
municate the disease or not. 

They were found free from leper bacilli when a subsequent 
bacteriological examination was made, but is the freedom perma- 
nent? I claim not. Examinations in leprosy should extend over 
months and years, so peculiar are the freaks of leprosy even in 
this twentieth century. This is one form of Carrier or Dubious 
Carrier of Leprosy. 

Second, amongst 124 females — Hawaiians, Caucasians and 
Chinese-Hawaiians, healthy in every respect excepting bladder, 
vaginal, uterine and ovarian diseases, whom I have examined in 
my gynecological work during the past sixteen years, the vaginal 
secretion in seven of these women contained the bacillus leprae, 
derived from specimens of mucous secretion taken just within the 
introitus vaginae. Specimens of the vaginal mucous taken far in- 
side the vagina and from the cervical canal showed no bacilli; 
which in all of the specimens did not count thirty bacilli on the 

slide. 

* * * 

These seven cases had all clean husbands, but had daily con- 
tact with female lepers. Under vaginal douches of sublimate 
solution, used to alleviate the various diseased conditions from 
which they were suffering, there was complete disappearance of 
the bacillus leprae, and on later examinations none could be found.. 

Any inference to be drawn from the cases must be purely 
speculative. 

What I do know from years of experience is this: The semi- 



THE PATH OF THE DESTROYER H3 

nal fluid frequently contains no leper bacilli, and neither does the 
menstrual fluid nor the vaginal secretions in the female leper. 

The presence of bacilli in the vagina I claim is an "accidental 
contamination/' they have no permanent habitat in that canal in 
the leprous female; cleanliness and douching with plain warm water 
will clear the vagina. The bacilli enter the vagina from the 
anus in uncleanly females, and the best proof is that cleanliness 
keeps the vaginal passage free. 

I have notes of examinations of forty-two leprous females in 
whom the vaginal secretion was carefully searched for bacilli, and 
only found in four cases. As stated in the above cases, cleanliness, 
with the use of soap and water ablutions of the anus, and plain 
warm water douches in the vagina, eliminated the bacilli, and 
repeated examinations thereafter failed to reveal their presence. 

In Hawaii, as in other countries where leprosy prevails, there 
is present abundance of evidence to prove that the disease is not 
conveyed by sexual intercourse ; this condition being apparent to 
both the laity and physicians. 

The fact that leprosy prevails amongst children of tender 
age, even as early as three years, should be also borne in mind, 
in considering this conclusion. 

I am convinced that the communication of leprosy by a leper 
to his or her healthy consort by sexual intercourse, as a means of 
spreading the disease, may be ignored. Hawaii bristles with evi- 
dence to support this claim. 

STERILE LEPER BACILLUS 

Carriers of leprosy can be found amongst the cases of neural or 
anaesthetic leprosy, which have apparently aborted or become ster- 
ile, such a condition may be temporary or permanent. Take the 
case where the chief visible evidence of the disease is the impli- 
cation of the nerves of the elbow and forearm, the median and 
ulnar, causing the claw hand and loss of surface feeling of the 
skin of the forearm, hand, and fingers; the typical hollow between 
the forefinger and thumb ; the adductor pollicis, and the first dorsal 
interosseus muscles being those especially attacked, which the ulnar 
nerve supplies. 

The leprous infection never makes any further progress, but 
leaves the hand permanently deformed and damaged, so that 
neurectasis, massage, or electrical treatment are of no benefit. 

This trophoneurosis of the hand is solely due to peripheral and 
non-central lesions, and is generally caused by infective neuritis. 




HAWAIIAN TYPE. 



THE PATH OF THE DESTROYER 115 

THE USE OF AWA A POSSIBLE CAUSE OF SPREADING 

LEPROSY 

The chewing of awa root, if the chewer is a leper, and the 
mixture that results, viz., awa juice, leprous saliva and water, is 
drunk by a healthy or non-immune person; it is certainly a most 
likely method of causing a limited spread of leprosy, because awa 
drinking is falling into disuse from year to year. Even when 
the use of awa was very much more in vogue than it is today, it 
was never a universal practice amongst the Hawaiians. Awa, kava 
are names given to an intoxicating liquid made in Hawaii from 
the root of the piper methysticum. It is in use in the Samoan 
Islands also. 

The intoxication produced by alcohol differs from that of awa ; 
the rapid pulse, mental excitement, loquacity, etc., are all absent. 
The awa drinker resembles a person under the influence of a nar- 
cotic. Awa intoxication makes the drinker silent, stupid, drowsy, 
with incoherent dreams; speech is affected, causing stuttering, the 
muscular power is much weakened, there is lack of co-ordination, 
and in the chronic drinker, temporary motor paralysis occurs. Awa 
acts more on the spinal cord than the brain. The chronic awa 
drinker becomes a most repulsive object, his conjunctivae are 
deeply suffused, injected, and thickened. Conjunctivitis with 
purulent discharge is a prominent feature, ectropion or eversion, 
ptosis, and thickening of the edges of the lower lid are also con- 
comitant symptoms; the skin becomes dry and harsh, and covered 
with scales which frequently cover the whole body and face. 

Apathy, uncleanliness and a general slovenly appearance fills 
in the picture, somewhat resembling the chronic alcoholic drunk- 
ard. Very advanced cases, to a certain extent, resemble leprosy, 
and it is sometimes mistaken for this disease. 

An alcoholic solution of awa root injected into the skin 
causes anaesthesia, followed by paralysis of the peripheral nerves 
for several hours. 

Internally awa is used for gonorrhoea, vaginitis, leucorrhoea, 
cystitis, and for kidney troubles by the Hawaiians. It somewhat 
resembles cubebs in its action. 

Foreigners use awa for gonorrhoea and cystitis. It is some- 
times prescribed by physicians in Hawaii for these diseases; also 
it is used in alcoholic solution, or unguent in pityriasis versicolor, 
in psoriatic affections in leprosy, and in Lichen ruber planus. 

The method of preparing awa in Hawaii is as follows: A 



116 THE PATH OF THE DESTROYER 

portion of the root is washed in water, peeled, and a sufficiently 
large enough piece to fill the mouth is introduced therein and 
chewed vigorously, the resultant solution of awa juice and saliva 
being ejected from time to time into a bowl or calabash. When 
all the juice is extracted from the chewed piece of the root a new 
piece is substituted. Sometimes a little water is taken into the 
mouth to aid the process. Perhaps two to three pints of saliva 
and awa juice may be obtained by the chewer. To all this, water 
is added to thin down the liquid and increase its bulk. This solu- 
tion of awa may be drunk fresh, but more often is put aside to 
ferment, which process begins in about twelve hours and is aided 
by the ptyalin of the saliva. 

The preparation and drinking of awa spittle is not pleasing 
to the eye or stomach, and where the chewer is a leper, a syphili- 
tic, or a tubercular subject, which is not rare, the prospect of con- 
veying any of these diseases to a healthy person is quite probable, 
and is much enhanced if abrasions or sores are present in the 
mouth of the chewer; he certainly is a dangerous person to pre- 
pare awa. Unfortunately, the Hawaiians cannot comprehend the 
risks of infection that lie in a diseased awa chewer. 

The Hawaiians are the only race in Hawaii who use awa; 
if the chewer is healthy, disease is not likely to be conveyed by 
its use. 

Awa made by a clean, healthy person contains no bacillus 
leprae, but if made by a leper, the bacillus is rarely absent. 

Awa drinking in Hawaii nei is generally confined to the adult 
portion of the Hawaiian race, and is not often used by the young 
members. 

/ claim that "here is an agent or factor in use," and peculiar 
to one race, that will account for a certain number of cases of 
leprosy; also that this disease can be conveyed to some healthy 
persons by drinking awa containing the bacillus leprae; if its use 
is frequent, then infection of the healthy victim is frequent and con- 
tinuous until his or her leprosy becomes developed and visible. 

I now conclude: "The bacillus leprae, in order to infect a 
healthy person, must enter the digestive tract through the mouth, 
from thence a general systemic infection occurs through the mu- 
cosae of this tract." 

Furthermore, most of the cases of leprosy can be accounted for 
by this method of infection. The human mouth is par excellence 
a situation for bacteria to develop, flourish, and obtain a temporary 
nidus, preliminary to passing into the stomach and intestines. 



THE PATH OF THE DESTROYER 117 

To sum upon this awa question : 

Drinking awa uncontaminated by a leper can be no cause for 
spreading leprosy, remote, or even predisposing; its main effect in 
chronic drinkers is, as I just wrote, to produce an artificial psoria- 
tic change in the epidermis and outermost layer of the dermis, 
conjunctivitis, thickening of the eyelids, and ectropion or eversion 
of the lower eyelids. 

On the other hand, contaminated or infected awa, a com- 
pound consisting of leper saliva or spittle extract of awa root and 
added water (just as often used by the chewer to wash his mouth, 
and from thence he ejects this washing into the awa mixture in the 
bowl), can most assuredly infect a healthy drinker. In this in- 
fected awa, there is every reason to conclude and believe that the 
bacillus leprae is alive; because the saliva affords one of the best 
media for developing bacteria, is free from pus and other morbid 
products (which tend to produce cadaveric bacilli) ; the even mouth 
temperature, and the bacilli also protected from atmospheric changes 
by their own cell wall and the viscid saliva. 

The bacillus leprae, introduced into the digestive tract under 
all the above conditions, is in one of the most advantageous posi- 
tions to carry infection. 

There are other agencies that I claim are more prominent 
and effective in causing the spread of leprosy than infected awa 
(I will discuss these later) ; all of which, in their use and con- 
sumption are peculiar to the Hawaiian race — the race chiefly 
affected with leprosy. 

Out of apparent evil often comes good, it is the dark cloud 
with the silver lining. In no other country of the world but 
Hawaii are the conditions, bearing on the means by which leprosy 
is spread, so favorable for its elucidation. It is practically a mono- 
race selective disease in Hawaii, a peculiar feature, and if we study 
all the causes leading up to this, we must reach, little by little 
(even if we blunder on to it) the truth and the answer to the 
questions: 

1. Why is leprosy so prevalent amongst the Hawaiian race? 

2. Why are the foreign races so little affected by the disease? 

3. By what means does leprosy infect a person? 

SALT FISH AN ALLEGED CAUSE OF LEPROSY 

Has salt fish, well cured or imperfectly cured, any inherent 
property that endows it with specific power to cause leprosy? A 



118 THE PATH OF THE DESTROYER 

theory promulgated by some authorities, who maintain "that a fre- 
quent salt fish diet is a chief cause of the spread of leprosy." 

This doctrine is not tenable, and cannot be brought into the 
field to illustrate the cause of leprosy in Hawaii, excepting in two 
special phases — a chemical and a mechanical — and both of these 
agencies are merely factors capable of conveying leprosy, but not 
producing it. 

Salt fish, when not infected by the saliva-coated fingers of the 
leper, can convey no leprosy, but if the salt fish is contaminated 
by the leper's fingers, it contains leprous bacilli, and certainly can 
infect a healthy person partaking of this leper-handled fish, pro- 
vided he is not immune. 

A leper eating fish out of the same dish as his healthy com- 
panion, pursues a method of eating wherein lies every possibility 
of infection of this companion. 

The leper's fingers convey pieces of fish to his mouth, which 
fingers carry saliva on the return from his mouth to the fish, and 
the process goes on all through the meal and at each meal — fingers 
from mouth to fish, and from fish to mouth, and so on, with con- 
stant repetition of the process. 

The mechanical aid that salt fish gives as an agent or factor 
in conveying the disease, consists in the more prolonged fingering 
required to detach the tenacious bone adhering to fish, in morsels 
suitable for the size of the mouth, especially when, as is usually 
the. case in Hawaii, the dry fish is eaten uncooked. The fingers 
of both hands have to be used for a long period in breaking up the 
dry fish to a suitable size for entering the mouth. At every por- 
tion of fish carried to his mouth the leper coats his fingers and 
finger nails with saliva, and, hence bacilli. 

The leper bacilli exist in large numbers in the mouth of the 
leper at the beginning of the meal, but whether the fish in the 
dish is continuously infected by the fingers of the leper, is diffi- 
cult to determine and the results obtained vary a great deal. Each 
and every contact of the leper's fingers with the fish is a risk to 
the person or persons eating with him. The fish present in the 
dish is fingered by the healthy eater, or eaters, who each takes a 
morsel of infected fish, then comes the leper's turn, then the 
healthy eater, and so on, until the appetite is satisfied ; all the fish 
being eaten at that meal, or the uneaten fish remaining in the dish 
being put aside for the next meal. In the interval, the contami- 
nated fish may be placed before some guest visitor, or an absent 
member of the family at meal time. This guest or visitor may 



THE PATH OF THE DESTROYER 119 

be a foreigner (a white man). Of course, the leper in the farm'])' 
does not appear to eat, or appear at all, but this visiting foreigner 
is fed with fish and poi, and if there are the remnants of fish 
left over from the last meal at which there was a leper eater, 
this foreigner or guest may or may not be unwittingly infected 
with leprosy, from the leper-infected remnants of poi and fish set 
over from this said meal. In the house of his friends, said for- 
eigner may eat time and time again in the same house and under 
the same circumstances, and then marvel where he contracted 
leprosy. (Here lies one illustration of the alleged mysterious spread 
of leprosy.) 

I have conversed with and questioned many foreign lepers in 
Hawaii, and put the question to some of them: "Did you have 
contact with lepers?" They all make generally the same answer: 
"I never saw a leper until I came here" (Leper Settlement), and 
next almost invariably is added, "I never have had anything to do 
with native women" — hinting at and thinking that I am a believer 
in the almost universally held idea in Hawaii that leprosy is spread 
by sexual intercourse. Continuing the questions, "Did you live, 
sleep, or eat in the houses of Hawaiians?" The answer comes, "I 
have lived and slept and I have eaten poi and fish when I was 
visiting or traveling around, but there was no leper present that I 
saw or heard of!" 

Often I have gotten the direct evidence I wanted — the foreign 
leper stating, as the case may be, "So and So is a leper here (Leper 
Settlement). I used to know him well; he never came to our 
house, but I went to his on a friendly visit and ate poi and fish 
with him, but he then had no leprosy." Just as often as not, other 
members of the family in the house where this leper foreigner had 
eaten, were lepers before his host and entertainer became one. 

Following patiently every clue, the spread of leprosy can gen- 
erally be traced, each case of leprosy to another case. It is no 
mysterious disease as alleged, the path of infection shows a trail, 
sometimes clear, sometimes hidden. 

Investigating the unknown and hidden features of any sub- 
ject, it is more prudent to seek simple causes and effects and ex- 
amine them carefully, before proceeding to study the more complex 
ones. 

Applying this reasoning to the solution of the cause of the 
spread of leprosy, we at first are struck at the marked selection 
•of that disease for the Hawaiian race. 



120 THE PATH OF THE DESTROYER 

Here we have an absolute fact, prominently outlined before 
our eyes. 

Next we may safely conclude that whatever race is the most 
affected with leprosy, here will be found abundance of material 
to work upon, and it will not. repay us to spend our time in the 
narrow field afforded by "sporadic cases,'' so-called, prevailing 
amongst foreign races in Hawaii. 

ANY FOOD that is handled by a leper is a possible source 
from which other cases of leprosy may originate, the infection be- 
ing carried by the fingers and finger nails. 

The specific infective principle is the leper bacillus, carried in 
the saliva-coated fingers. If the leper has ulcerated fingers, I as- 
sume there is no added risk, because an ulcerating pus secreting 
surface, carrying bacilli in contact with the air, are in all prob- 
ability cadaveric. The limitedly contagious character of leprosy 
to those in contact daily for years, adds weight to my assumption. 

The more finger contact any article of food receives from a 
leper, the greater the probability of more intense infection of that 
food with bacillus leprae. Salt fish, owing to its tenacity and 
bone-adhering properties, is pre-eminently an article of food, where 
the mechanical factor comes into play (illustrating that salt fish 
plays the role as an agent or factor of conveyance only, for the 
bacillus). Salt fish generates no bacillus leprae de novo, and no 
bacilli are found in the fish until the leper infects it. 

Salt fish does contain even when properly cured, Forster's 
bacillus, motile circular or irregularly circular bacilli, but this 
bacillus is non-pathogenic, and resembles in no manner of way the 
bacillus leprae. 

EXPERIMENTS WITH FISH 

Portions of salt salmon, mullet, akule and aku, all fish in 
common use daily amongst the inhabitants of Hawaii, were care- 
fully washed, triturated in a mortar, and the washings carefully 
examined and found free from the bacillus leprae. 

Portions of these same fish, uncooked, were given to lepers 
to chew and churn up in the mouth, the chewing continued for 
two minutes actual time. The contents of the mouth being then 
ejected into a sterilized cup and the contents carefully examined. 

During twenty-five years, at various times and places, I 
carried on these experiments on sixty-five leper male and female 
adults, all cases being mild or moderate ones — no advanced cases 
were taken. Out of these sixty-five cases, fifty-three of the slides 



THE PATH OF THE DESTROYER 121 

showed numerous leper bacilli, and in remaining twelve cases no 
bacilli were discoverable. But this need not be taken as absolute 
negative evidence, it holds good simply for the examination at 
that date. 

In the face of all this evidence, it is reasonable to assume 
THAT THE USE OF CLEAN SALT FISH, PER SE, IS 
NOT A SPECIFIC CAUSE OF LEPROSY, BUT WHEN 
INFECTED OR CONTAMINATED BY THE LEPER IT 
ACTS ONLY AS AN AGENT, FACTOR, OR MEDIUM 
OF CONVEYANCE OF THE BACILLUS TO THE 
HEALTHY. 

To sum up : 

THE CLAIM THAT EATING SALT FISH IS A 
CAUSE OF LEPROSY, OR A CAUSE OF THE SPREAD 
OF LEPROSY, CAN ONLY BE MAINTAINED BY AS- 
SUMING THAT PREVIOUS INFECTION OR CONTAM- 
INATION OF THE FISH BY LEPROUS CONTACT 
MUST HAVE TAKEN PLACE. 

SALT FISH A CHEMICAL FACTOR IN LEPROSY 

Salt fish, by reason of its contained salt and daily use, tends 
to alkalinize the saliva and diminish the acidity of the gastric 
juice in the stomach; by both of these chemical changes in the 
composition of these secretions, the bacillus leprae is more likely to 
flourish and live in the digestive tract. 

The excessive use of salt as an article of diet with any food 
also tends to bring about the same result. The Hawaiians do eat 
largely of salt — the poi, their staple food, a starchy paste, is insipid 
and tasteless without salt. 

The salt in use in the Hawaiian home is not the refined 
powdery salt like that in use on a foreign dining table, but is 
composed of large, coarse crystals, which crunch under the teeth 
like our rock salt. This Hawaiian salt is much more saline, biting, 
and savoury than refined salt; bitter also, from excess chloride ot 
magnesia. As an alkalinizing agent, it is far more effective than 
ordinary table salt. 

By actual investigation and test, I found that an average Ha- 
waiian eater consumes from one and one-half to three tablespoon- 
fuls of this coarse salt at each meal. 

This excessive use of salt is a serious drawback to digestion ,- 
skin troubles, stomach disorders, and kidney irritation, prevalent 



122 THE PATH OF THE DESTROYER 

amongst the Hawaiian race, can all be traced to the excessive use 
of salt. 

The mouth is a favorite seat for the development of many 
bacteria — alkaline saliva, high, steady temperature, decaying and 
fermenting particles of food adhering to and lodging between the 
teeth, caries of the dentine — all furnish a suitable nidus. Six 
known bacilli, peculiar to the mouth, find a permanent home in 
unclean mouths. 

Several micrococci, Friedlander's pneumonia bacillus, Frank- 
el's pneumococcus, diphtheria bacillus, tubercule bacillus, syphilis, 
and leper bacilli, all find a lodgment and home in the mouth. 

The saliva is generally alkaline, but not in every person, and 
by using litmus paper, four different states are revealed — faintly 
acid saliva, neutral, alkaline, and strong alkaline. The excessive 
use of salt produces the two latter conditions, which favors the 
development of bacilli of typhoid, cholera, leprosy, and many others. 

The stomach in its normal condition is not suitable for the 
development of bacteria, but many germs can withstand and survive 
the action of the gastric juice. 

When the acids of the stomach are weakened, or even neutral- 
ized, which happens at intervals, bacteria are placed in a more 
favorable medium for their growth ; in like manner, the excessive 
use of salt by the Hawaiian race can produce this very condition 
of the stomach which will aid the bacillus leprae. 

It is from this view, "eating salt fish in excessive quantity," 
that brings out the chemical agency, or factor, or quality that aids 
the spread of leprosy. The salt in salt fish, by its alkaline prop- 
erty, changes the gastric juice, and also the saliva in composition, 
the acidity of the former being much diminished and alkalinity of 
the saliva made strongly alkaline. 

The salt in the fish, if the fish has been infected by leprous 
contact, merely acts as an agent, factor, or medium of assistance, 
by its alkaline property on the secretions of the mouth and stom- 
ach, and only to this extent does it aid and favor the development 
of the leper bacillus in the digestive tract. The excessive use of 
salt in the diet or its absence is no specific cause of leprosy. 

By experiment and test. 

Refined Granular Table Salt 

60 grains added to a l-to-500 solution of H. Cl.=Faintly Alkaline. 
80 grains added to a l-to-500 solution of H. Cl.=Neutral. 
100 grains added to a l-to-500 solution of H. Cl.= Alkaline. 



THE PATH OF THE DESTPnyER 123 

Coarse Crystallized Hawaiian Salt 

30 grains added to a l-to-500 solution of H. Cl.=Faintly Alkaline. 

50 grains added to a l-to-500 solution of H. Cl.=Neutral. 

65 grains added to a l-to-500 solution of H. CI. =Alkaline. 

80 grains added to a l-to-500 solution of H. Cl.=Strongly Alkaline. 

If the standard of alkalinity of the saliva is to be gauged by 
litmus paper, then it will be necessary to modify the statement that 
the saliva is an alkaline fluid at all times. 

The saliva from time to time varies in its reaction to litmus 
paper, being acid, faintly acid, neutral, alkaline, and strongly 
alkaline. 

The saliva in man is a clear, viscid fluid, secreted by the 
salivary glands. It contains ptyalin, its chief active constituent, a 
digestive ferment; the saliva lubricates the mouth and softens and 
moistens the food, thereby aiding mastication and deglutition. 

The ptyalin converts starch into maltose (malt sugar). 

The saliva is secreted by the submaxillary, parotid, and sub- 
lingual glands; lingual saliva is secreted by the glands of the tongue. 

Parotid saliva contains no mucin (a protein). It is thinner 
and less sticky than the other varieties. 

Sublingual saliva, from the sublingual gland, is the most viscid of 
the salivas, its reservoir or pocket under the tongue is a favorite 
location for the bacillus leprae. 



CHAPTER II. 
Deductions. 

1. Having weighed and considered the extreme com- 
plex features surrounding leprosy in its multiple and varied 
aspects, I assume and maintain that leprosy is a primary mouth 
infective bacilligenic disease. 

2. I also assert and maintain that man is infected by 
leprosy through the mouth, and its connecting passage, the ali- 
mentary canal, or digestive tract. Also that the bacillus 
leprae first finds lodgment and nourishment in this canal, and 
thereafter reaches its various selective tissues of the body by 
penetrating the mucosae of this same alimentary canal, di- 
gestive tract or path, (hence my selection for the name of this 
monograph). 

'The Path of the Destroyer." 

3. The mouth with its contained saliva in the confirmed 
leper is the main source of contagion to the healthy. 

Man is infected through the mouth in seven- tenths of 
the cases of tubercular or nodular leprosy. 

I have not yet reached a conclusion on the many differ- 
ent features of the nerve form of leprosy, but in so far as I 
have gone, "mouth infection" will also explain the manner of 
infection in this form of the disease. 

If we could check, stop, or shut off pulmonary infection 
in tuberculosis, we would shut off nine-tenths of the cases of 
that disease, because primary pulmonary infection will account 
for nearly all the cases: Local T. B., bone T. B., Glandular 
and Intestinal T. B. alone remaining. Similarly if we could 
shut off mouth infection in leprosy seven-tenths of that disease 
would be shut off, and we might possibly eradicate it. 



THE PATH OF THE DESTROYER 125 

POI VS. LEPROSY 

Clean poi, fresh or sour, contains no bacillus leprae, but poi 
infected or contaminated by leprous saliva-coated fingers and fin- 
ger nails contains the bacilli, and is a menace to a healthy or 
non-immune eater. I claim it is ONE of the chief agents that 
has caused, and causes, the spread of leprosy amongst the Ha- 
waiian race. 

Of all the people domiciled in Hawaii, the Hawaiians alone 
are the main eaters of poi; this peculiarity of food is almost en- 
tirely confined to them, and also with monotonous repetition I add, 
they are the race for which leprosy apparently has a remarkable 
predilection. 

Poi is a sticky, bluish gray paste, made from the root of the 
taro plant, arum esculentum. It grows in shallow ponds or 
patches, with soft mud bottom, covered with water to a depth of 
about one foot. There are many species of taro, both of the wet 
kind and dryland kind, which grows at an elevation of about 
1,200 feet above sea level; this taro receives its moisture from the 
rain and dews. The water-grown taro is the staple article of 
diet, and forms the daily food of 95% of the Hawaiian people. 

The root is cooked, peeled and pounded to a paste with added 
water. The flour paste of the bill-poster or the paper-hanger is 
poi counterfeited except for the color, and this flour paste poi is in 
common use today, instead of taro poi, owing to the high price of 
taro. 

Poi is easily assimilated and is highly nutritious. Within a 
few hours after being freshly prepared it begins to sour, due to 
the starch largely present in its composition, taking on amylaceous 
fermentation. 

The insipid taste of fresh poi palls on the Hawaiians, and 
they prefer poi which is two or three days old. Abundance of 
salt is also eaten with poi to remove its insipidity and lack of relish. 

The containers for the poi are wooden bowls, calabashes (so- 
called) or true calabashes — large dry gourd shells, or porcelain 
bowls of foreign manufacture. The family calabash is of large 
diameter, rarely less than twelve inches, and when full contains 
an average depth of ten inches of poi. The calabash of poi is the 
recipient of all the fingers of the eaters who surround it and are 
in sufficient contiguity; these details fill in a picture of pleasure, 
health and ultimate satiety, provided all the eaters are healthy. 

I will ask the reader to picture in his mind six people sitting 



r 




THE PATH OF THE DESTROYER 127 

around a dish, and all eating out of this dish with their fingers 
coated with flour, or starch paste, or poi, a tenacious compound 
requiring the finger to be deeply inserted into the mouth, and 
strong suction applied to remove the paste. 

I now turn on the light of a morbific current, and ask the 
reader to imagine what would happen to these six eaters, if some 
ignorant, thoughtless person semi-convalescent from cholera or ty- 
phoid fever (both primary mouth infective diseases), or a syphilitic 
with recent mucous mouth lesions, were to stir round this dish of 
paste or poi with unwashed, infected, and unsterilized hands, and 
begin eating and eating until he had finished his meal, and after 
him the six eaters began to eat the same poi or paste with its 
possible disease infecting contents — this same occurrence happening 
at the three daily meals. 

Any person of common sense will admit, that the danger of 
infection from the above diseases to the six innocent eaters is very 
great. 

Now this is exactly what takes place when a leper eats out of 
the same poi bowl with other healthy eaters. Amongst the Ha- 
waiians the leper sits right amongst them, puts his fingers into 
the same food that they, the non-lepers eat, they know of his pres- 
ence and avoid him not, and this condition goes on maybe for 
months or years. 

Then one of the eaters with the leper develops the disease 
(leprosy) : this makes two lepers. These two lepers remain eating, 
sleeping, and living with the other healthy occupants and another 
case of leprosy shows up later on; afterwards, either from immu- 
nity or some other accidental protective precaution (separate eating 
bowls, perhaps), no other inmates of the house develop leprosy, then 
the disease will be looked on as non-contagious by the surrounding 
neighbors. (This is the picture presented to us physicians in Ha- 
waii, and it is not overdrawn, it occurs daily.) 

FROM THE ABUNDANCE OF EVIDENCE AND 
VISIBLE PROOF OF THE SPREAD OF LEPROSY IN 
THE HAWAIIAN ISLANDS, IT IS HARD TO CONCEIVE 
HOW ANYBODY, LAYMAN OR PHYSICIAN, CAN 
DOUBT THE COMMUNICABILITY OR CONTAGIOUS- 
NESS OF LEPROSY. WHAT DULLS AND BLINDS THE 
REASONING FACULTIES OF THE NON-CONTAGION- 
ISTS IS THE SUPPOSEDLY SLOW PROGRESS AND DE- 
VELOPMENT, APPARENT IMMUNITY SO MANY 
SEEM TO POSSESS, AND THE IMPERCEPTIBLE MAN- 



128 THE PATH OF THE DESTROYER 

NER, APPARENTLY, OF ITS COMMUNICATION, 
WHICH HAS LED THEM TO ASSUME THAT LEP- 
ROSY IS NON-CONTAGIOUS. 

In contact with disease, the Hawaiian, without specially be- 
traying his creed, is a believer and apostle of fatalism. Careless, 
even to recklessness, whether the disease be bubonic plague, cholera, 
tuberculosis or leprosy, with which he is in contact, the Hawaiian 
stands his ground, makes no attempt, to move away from the point 
of infection or to protect himself or take any precautions what- 
ever; but when he becomes a victim of a fatal disease two states 
of mind will be in evidence, utter sangfroid and stoicism, or pa- 
thetic appeals for aid when it is too late. 

During the time I have lived in Hawaii — over thirty-two 
years — I have been amused and interested in observing the prac- 
tice of the native doctors whenever opportunity presented itself. 
Implicit confidence is placed by the Hawaiian in the skill and 
learning of his kahuna, kauka, or doctor, but lack of confidence 
and fear generally is the rule when brought in contact with a 
foreign physician, who is lacking the essentials of Hawaiian prac- 
tice, porcine and gallinaceous beliefs. 

The native doctor is generally crafty, shrewd, and at times 
unprincipled. Whatever skill the ancient Hawaiian physicians 
possessed, in modern times like today it is a lost art, and most, of 
its graduates belong to the university or school of superstition. 
The modus operandi of the Hawaiian doctor is as follows: In- 
cantation for the recovery of his patient plays a minor role, as also do 
the medicines he administers, but he himself (the doctor) requires 
his fee and also that he shall be fed on the best of the land — suc- 
culent pig, chicken, gin or brandy and so forth. This high living 
is essential, for if the kauka becomes weak or feeble (a very com- 
mon occurrence), the disease in his patient's head, lungs or stom- 
ach will get the best of him (the doctor) and then death stares 
the patient in the face. Therefore, the doctor must live on the fat 
of the land while his patient may starve. 

Often times when the financial limit of the patient is ex- 
hausted and his death is becoming apparent, the kahuna, seeing 
no more prospective fees, and to save his own neck (being un- 
licensed) urges the patient and his friends to seek the services of 
a foreign doctor, telling them, "the nature of the disease has 
changed to a foreign sickness, and hence the need of a haole or 
foreign doctor!" 

I have given dozens of death certificates, knowing full well 






iiii 







Ol'R HARBINGER OF HOPE. 

We have here our Venerable Medicine Man — 

Kauka Kukaepele, M. D. (Doctor Sulphur). 

A Distinguished Member of the Faculty. 

Note the placid features of the Kauka. He is taking his dail\ sun bath, 

and his favorite laau — popolo — this accounts for the Doctor's hue physique, 

and contempt for haole hair restorers. 

Observe the Doctor's left hand possesses six fingers. The average white 
doctor has only four fingers, which amply suffice to abstract fees from his 
patients' pockets. 



THE PATH OF THE DESTROYER 129 

that I was covering up the work of a kahuna. What else could 
be done? the body must be buried, no evidence could be obtained 
proving negligence or malpraxis, and if prosecution was undertaken, 
acquittal would be certain, Mr. Kahuna would triumph and pose 
as a martyr of haole persecution. The average native judge gets 
"cold feet" in a kahuna trial. 

The Hawaiians dread the power of the kahuna, regard him 
as an ogre. 

To resume the consideration of the subject of poi. 

Leprous bacilli can be found in the leper's calabash; this is 
highly significant, and is a striking indication that the leprous bacillus 
has a clear field for entering the digestive tract of a healthy person, 
eating out of the leper's calabash. The poi, of course, only acting 
as an agent, medium, or factor of conveyance of the bacillus leprae 
which originally was conveyed ' to the poi by the saliva-coated fin- 
gers of the leper. 

EXPERIMENTS ON POI INFECTION 

In order to test this method of infection, I experimented on 
twenty lepers during twenty-five years from 1884 to 1909, on 
every island of the group except Niihau. 

The leper was instructed to put his fingers to his lips, the 
index and middle fingers, and insert them well into the mouth as 
done in sucking off the poi; next step, the fingers were plunged 
into the poi, the exact spot being marked. Immediately a sterilized 
test tube of the largest size was pushed into the poi, at the spot 
where the fingers of the leper had been inserted. The cylinder of 
poi thus obtained was carefully examined, and in the whole series of 
twenty cases the bacillus leprae was obtained easily in every case. 

Again, I secured the washings from the leper's calabash, when 
it was being cleaned, and also obtained bacilli. 

Outside the body of the leper, his aw a, his salt fish, and his 
poi, all contain bacilli, and possibly other articles of food also. 

The saliva of the leper, a secretion in which it is reasonable 
to assume the bacilli are alive (and I claim that the saliva of the 
leper is not likely to contain cadaveric bacilli), is the only se- 
cretion in direct contact with the air, where non-cadaveric bacilli 
should exist — no clothing covers the oral orifice, hence direct trans- 
fer of the bacilli from this locality is more likely than any other. 

The tears of the leper contain no bacillus leprae. The pos- 
terior nasal secretion contains bacilli which pass into th* phi 



i n'ov 




PREPARING THE POL 



The pestle or pounder in the man's hand, the poi board or platter with 
poi, ready for placing in the calabash visible in the background. The tare 
plants, sheath and root in the foreground. 



THE PATH OF THE DESTROYER 131 

and back of the throat, they would therefore reinforce the bacilli 
at the back of the mouth and base of the tongue. 

The secretion of the anterior nares, pouring out on to the 
upper lip, I claim, having free contact with the outer air, lacks 
infective properties, the bacilli are weakened, possibly cadaveric, 
and if some of this nasal discharge enters the mouth, which it 
must do at times and in sleep, mixing with the bacilli of the 
mouth, it will simply augment the numbers of bacilli in that cavity 
but not add to infective power of the saliva. 

Rice, bread, crackers, raw fish cut in pieces will present less 
surface for infection by the leper's fingers than poi or salt fish. 
These former articles of food require less handling to detach a 
piece suitable for the size of the mouth. 

In rice, a spoon is generally used for eating; if the fingers, the 
fingerful is pulled cleanly away, the remaining rice is not messed 
or mixed up by the leper's fingers. 

This same statement applies to bread and crackers or biscuit 
if eaten whole, and not broken piece by piece in a common dish by 
leper fingers. 

All these foods are less fingered than poi, which takes the 
first rank in finger contamination and in the depth of entrance of 
the finger into the mouth, the compression of the lips and cheeks 
aiding the strength of the act of sucking; the finger nails also 
aid the carrying of bacilli, practically the fingers with each 
plunges into the poi concentrate and mix in bacilli. The poi is 
cold when fresh, but the fermentative process always present after 
the first day, produces warmth which must aid the bacillus. Hot 
cooked food, or cooked over food would most likely destroy the 
bacillus, but fermentation would scarcely reach any damaging tem- 
perature high enough to end bacillary life. 

One Hawaiian method of kissing, pushing the tip of the 
tongue into the opened lips and mouth of the kisser or kissed is a 
dangerous practice, if one or the other happens to be a leper, 
tuberculous or syphilitic, etc. 

In Hawaii the leper receives the "maximum of contact" with 
the healthy, eating, sleeping, living in the same room, and the 
longer I observe these conditions the more I wonder that there are 
not more lepers. 

The opinion is held by some, that the saliva-coated finger of 
the leper when covered with poi prevents any infection of the poi 
in the calabash, the bacilli contained in the saliva being sucked 
again into the mouth with the poi on the finger. 



132 THE PATH OF THE DESTROYER 

In a slow eater this condition is a plausible possibility, but 
the leper has generally a voracious appetite, due to his diseased 
stomach, and proceeds to scoop up the poi from the calabash as fast 
as possible, and during this process he scatters minute droplets of 
saliva, visible and invisible, over the surface of the poi, also with 
each plunge of the index finger, the bent second phalanx of the 
adjoining finger, together with the terminal phalanx of the 
thumb, come in contact alternately with the leper's mouth and the 
surface of the poi. 

The presumption that the coating of poi on the leper's finger 
is of sufficient non-permeability to isolate a bacillus like the bacil- 
lus leprae, 3m (microns or micromillimeters) in size, a micron being 
equal to 1/25,000 of an inch, and also the fact that 10,000 bacilli 
could easily occupy the surface of an ordinary finger nail, throws 
grave doubts on the correctness of the above assumption that a 
leper eating poi does not contaminate or infect it. 

I have stated already that in the cleansing of the leper's 
calabash the bacillus leprae can be detected in the washings, irre- 
futable proof that the leper does infect the poi. 

SUMMARY OF CAUSES ALLEGED TO SPREAD 
LEPROSY IN HAWAII 



Common 


to 


all Races 


Indigenous and Peculiar to the Hawaiians 


Vaccination. 






Poi eating with leper. 


Mosquitoes. 






Eating raw fish with leper. 


Bed-bugs. 






Eating uncooked food with leper. 


Fleas. 






Excessive use of salt. 


Pediculi. 






Awa drinking with leper. 


Sarcoptes Hominis. 


Eating with fingers. 



SOCIAL HABITS PECULIAR TO HAWAIIANS 

( Intimate ------ \ Marrying 

Leper Contact I Prolonged -----> Living 

( Promiscuous - - - - J Sleeping 

RACES NOT EATING WITH LEPER 

Practically all Caucasians and Asiatics 

* * * 

On the subject of pediculi or lice, sarcoptes hominis or itch, 




ft-- in "S*'^ 



r/i/ » 






,Mj \ $ 'Tiff. 
,l ■■#*■ 




CAUCASIAN-HAWAIIAN. 



134 



THE PATH OF THE DESTROYER 



as possible spreaders of leprosy, I have grave doubts if either of 
these parasites could infect man with that disease; if an affirmative 
answer is given, "then these parasites must be looked on as spread- 
ers of syphilis, tuberculosis, etc." What physician can assume this 
position? The direct entrance of the bacillus leprae must be 
looked for in the digestive tract, as I have before stated and dis- 
cussed. 



SIGNIFICANT CONDITIONS 

The last American census, year 1910, enumerated 

Asiatic-Hawaiians 3,734 

Caucasian-Hawaiians 8,772 

The Asiatic-Hawaiians are in the main comprised of Chinese- 
Hawaiians, who total possibly 90% of the whole. Leprosy does not 
prevail extensively among them, they are much less affected with that 
disease than are the Caucasian-Hawaiians, and both of these races 
suffer much less than the indigenous or aboriginal Hawaiian. 

Exact figures are difficult to obtain, but a fairly accurate 
ratio of the prevalence of leprosy amongst each of these three races 
is as follows, computed for thirty years, 1884-1914: 



Race 


Unit 


Ratio 


Hawaiian -... 


lto 
lto 
lto 


32 


Caucasian-Hawaiian 


140 


Chinese-Hawaiian 


210 



Caucasian-Hawaiian 
Chinese-Hawaiian 



LEPER POPULATION 

Thirty Years (1884-1914) 

One Leper to Every Seven 



{« 



Aboriginal 
awaiians 



This ratio is figured on the list of segregated lepers for the above 
period of thirty years. 

The Caucasian-Hawaiian is generally an eater of poi, due to 
the fact that the Hawaiian mother is usually the dominant con- 
sort in the matter of food supply, hence its more frequent use 
than rice or bread, due also the fact that in former years poi 
was much the cheapest of these foods. 



THE PATH OF THE DESTROYER 135 

As a general rule the Caucasian father is not as careful a 
provider, or as good a disciplinarian as he should be; laxness is 
the rule in both of these necessary paternal qualities. The daily 
food of the Chinese-Hawaiian, as long as he or she dwells under 
the paternal roof, is for the most part rice. The Hawaiian mother 
naturally, and from her bringing up, prefers poi to rice, and these 
two articles of food will be more likely to be found in her 
home than in the home of a Caucasian-Hawaiian family. 

What I have written, some pages back, that poi is a much 
better vehicle for conveying leprosy "when infected by leper fin- 
gers" than rice, receives further support when it is apparent that 
the prevalence of leprosy is greater amongst the Caucasian-Ha- 
waiian poi eater than amongst the Chinese-Hawaiian rice eater. 

The evidence that I am continually deducing all has the 
same trend, and always points to the digestive tract as "the path 
of entrance of the destroyer" (the bacillus leprae into the human 
system ) . 

A JAPANESE POI EATER 

On the lands of a certain mercantile enterprise employing 
over 1,500 Japanese men, there lived a Japanese, one of the 
number of these laborers, and pursuing the same vocation as the 
majority of them, viz. : working in the fields. 

This Japanese had resided in Hawaii for thirteen years, had 
always lived and worked on the same plantation. In the thirteenth 
year of his residence he became a leper, and for eleven out of 
thirteen years, until his leprosy showed itself, he had resided with 
a Hawaiian family. His diet was poi, which, of course, in a Ha- 
waiian household forms the daily family meal three or more times 
a day. 

This Japanese laborer had almost entirely discarded rice as 
his daily food, and he only ate that article of diet when he visited 
his friends. 

When I first saw the man, although he had marked signs of 
leprosy, it had not become well known that he had this disease, 
but his Hawaiian house companions easily recognized it in its 
early stages. 

I interrogated this Japanese and got his history as before re- 
lated ; it also came to light that in the Hawaiian house where he 
resided, there was a leper, a male Hawaiian adult, who ate pro- 
miscuously with all the members of the family and inmates of the 
house. 



136 THE PATH OF THE DESTROYER 

Here is an instance of one man out of 1,500 others develop- 
ing leprosy under the very conditions that I assume are the means 
of spreading the disease amongst, the Hawaiians. 

I questioned this Japanese leper on his family history and 
contact with leprosy in Japan, and the possibility of his carrying 
the disease with him; his answers to all my questions negatived 
the idea of his acquiring the disease in his home country. 

Provided Japan was free from endemic leprosy, the history of 
this Japanese laborer would furnish very positive evidence on the 
point I have previously claimed, viz.: the leprosy carrying quali- 
ties of infected poi. The weak link in the chain of evidence is 
the bare possibility of Japan being the country where the primary 
infection occurred. 

Thirteen years, however, is a long period of latency even for 
leprosy, which alternates its periods of activity and quiescence 
in a manner peculiar to itself, and different from all other known 
diseases. 




CHINESE-HAWAIIAN. 



CHAPTER III. 

INOCULATION 

Inoculation may be considered under two headings: Accidental, 
known or unknown, and Positive Inoculation. 

Accidental inoculation infers the infection of a skin wound 
with no desire to acquire or produce pathogenic conditons. 

Positive or deliberate inoculation may be defined as the in- 
sertion of a virus into a wound of the skin with the ultimate object 
of communicating a pathogenic infection. 

My own experiments, extending over many years, have led 
me to conclude that leprosy cannot, be inoculated on any dermal 
surface in man or animals by ordinary methods. This experience 
being in accord with the results previously attained by most workers 
in the field of inoculation. 

In spite of the barren results obtained and the failure of the 
attempts to inoculate man with leprosy, there is a widespread idea 
and opinion held by many physicians and the laity in Hawaii, 
that inoculation is the mainly responsible agent for the spread of 
the disease. This fetich will not down, it dies a hard death. 

The many years of toil and study that I have spent investigat- 
ing the subject of, "where and how does the bacillus leprae enter 
the human system?" I have previously detailed in past pages, (all 
the facts deduced on this subject clearly indicating the digestive 
tract), and this evidence would appeal with greater and more con- 
vincing force to physicians in Hawaii, were they not enchanted 
and hypnotized by the song of the siren of inoculation. 

To assume that the extensive prevalence of leprosy amongst 
the Hawaiians is due to inoculation, is a most unstable claim. 
Until leprosy can be demonstrated to be positively conveyed by 
inoculation, and inasmuch, even then, as no race has a possible 
monopoly of inoculation as a medium for communicating leprosy, 
it can hardly be conceived and accepted, that the Hawaiian race is 
alone susceptible to inoculation, and that all other races in Hawaii 
escape being infected with leprosy because they cannot be inoculated. 
This is a most untenable contention, yet it is the threshold on which 
believers in inoculation must stand in Hawaii nei. 

INOCULATION EXPERIMENTS. 

In the year 1844, Dr. Daniel Danielssen, Norwegian physician, 
veteran leprologist, (Danielssen's disease, Anaesthetic or Neural 



THE PATH OF THE DESTROYER 139 

leprosy being called after him), inoculated himself, two assistants 
and one nurse, attendants, at the Bergen hospital, with leprous 
blood, serum, and blood from leprous tubercles, and failed to in- 
fect himself or any of the others with leprosy. 

In the year 1856, at the Lungegaarde hospital, Danielssen again 
inoculated himself, and four other persons, the same fluids of the 
leper's body being used. No subsequent infection with leprosy oc- 
curred in any of these five persons. 

In the year 1858, Danielssen again inoculated two persons with 
the same leprous fluids, no resulting leprosy developed. 

From the years 1868 to 1875 in Italy, Doctors Guiseppe 
Profeta, and Cagnina inoculated themselves and eight others with 
leprous fluids, blood and blood serum. The whole ten persons so 
inoculated failed to develop leprosy in a single instance. 

If deliberate attempts fail to inoculate man with leprosy, it 
must then be a vague and doubtful possibility whether man can 
be inoculated by accidental and unknown conditions. 

In previous pages I have brought forward the vast field that 
European leprosy affords us, to ponder over and consider, and the 
great aid it gives us in studying the disease in Hawaii. In Europe 
a disease that numbered its victims by millions, ultimately almost 
became extinct, can scarcely be claimed to be a disease spread solely 
by inoculation. 

Syphilis has been known for many centuries to be inoculable, 
but there are no present indications of the disease dying out. 

We do not know that leprosy is inoculable in man. Were we 
positive in our knowledge that it was, would we expect it to be- 
come extinct? — the answer must be NO, for in the absence of rigid 
preventive measures, any inoculable disease widely spread, is very 
unlikely to disappear, and certainly not a chronic infective disease 
like leprosy. 

Syphilis, an inoculable disease remains with us, and no country 
is free from it; on the other hand leprosy for the most part has 
ceased to exist, but yet maintains itself by certain endemic centers 
in a few countries. 

All the evidence in Europe tends to strengthen the non-in- 
oculable character of leprosy, otherwise we must be led to accept 
the statement, that a "disease which scourged Europe for 600 years 
and over, died out of its own accord, was spread by inoculation," a 
deduction open to grave criticism, because this source of communi- 
cation, (inoculation) existed from the beginning, all through the 
course of the disease, even to the end, remains today as a universal 



140 THE PATH OF THE DESTROYER 

cause; and the same field for its spread is as open as ever; yet, 
only -limited areas of certain countries contain endemic centers. 

INOCULATION EXPERIMENTS ON KOKUAS AT 
MOLOKAL 

In the incipient stages of leprosy, it is natural to conclude 
that it would be possible to start fresh foci of disease in clean, and 
uninfected parts of the body of a leper by inoculation. If we 
could successfully accomplish this, it would be a great advance and 
we could learn much more about the etiology, the inoculability, 
period of incubation, etc., and make definite progress in our knowl- 
edge of the cycle or life history of the bacillus leprae. 

This is one of the first snags I encountered in investigating 
the pathogenic features of leprosy; the creation of "FRESH FOCI" 
of leprous infection in the leper cannot be accomplished, I never 
succeeded in doing so, the many experiments I carried out on this 
"LEPROUS RE-INFECTION" basis all ended in failure. 

Whilst the non-successful production of new infection centers, 
weakens the probability of certain local lesions of leprosy being of 
purely local origin, it by no means negatives the position maintained 
by some leprologists, that in certain lepers, leprosy has well defined 
local foci of disease, which if eradicated by excision, general systemic 
infection will be lessened or stopped. 

To proceed. Thirty years ago the Leper Settlement on Molo- 
kai maintained abundance of healthy kokuas, all ready and willing 
to be experimented on by inoculation, serums, or any other means 
likely to develop leprosy; the artificially made lepers hoping to 
obtain board and lodging, for the remainder of their lives; being 
listed as lepers — a livelihood, and existence without working being 
provided by the Board of Health. 

What other country of the world save in Hawaii, would people 
be found willing to take the chances of acquiring a loathsome and 
incurable disease?, the sole object to be gained for the loss of health 
and shortened lives, being maintained at public expense. From the 
Hawaiian point of view no risk attends a careless contact with 
leprosy; this condition alone ought to furnish sufficient evidence to 
the world, and account for Hawaii being a strong, and prolific 
endemic focus for that disease. 

Amongst the greater number of the 225 male and female 
kokuas residing at the Leper Settlement, in the early '80's, there was 
an ever present desire amongst them to be placed on the books and 
listed as lepers. 



THE PATH OF THE DESTROYER 141 

I was pestered and annoyed daily with requests to examine 
purposely caused lesions of the integument, generally consisting of 
incised, contused, or lacerated wounds, wilfully allowed to fester, 
and become ulcerated, aided and aggravated by irritating substances, 
salt, tobacco juice, sulphur, kerosene oil, acrid juices from raw taro, 
awa, soot, salt petre, and a multitude of other substances all calcu- 
lated to produce superficial or deep inflammation of the skin. 

Feigned pains, aches, paralyses and anaesthesia, all made to 
order, to fool the doctor. To imitate the leprous alopecia of the 
supra-orbital ridge — plucking out, and burning of the eyebrows was 
resorted to ; counterfeit leprous ulcers of the plantar surface of the 
feet were also common forms of malingering. 

A splendid field for experimental work was at hand, and 
stretching all questions of professional ethics, I did not hesitate to 
avail myself of the opportunities afforded me for testing the 
inoculability of leprosy. My chief regret is that I have so little 
to offer in results obtained on this much debated question. 

Over a period of three years, I selected ten male kokuas, and 
five female kokuas, suitable in every respect as subjects for experi- 
mental inoculation. 

A preponderance of cases of leprosy generally develop between 
the ages of 20 and 35 years; there is apparently at this period of 
life some real or apparent susceptibility to the disease, and these 
fifteen selected kokuas fell within the above age period. 

"A." Male Hawaiian kokua, 31 years of age, free from 
leprosy, had resided four years at Kalaupapa with his leper wife, 
her disease being of six years standing. 

This man claimed that various sores on his arms, body, and 
legs were due to "Mai Pake" or leprosy, and demanded that he be 
placed on the books of the Settlement and listed as a leper. 

The imposition was easily apparent, the wounds on the skin 
being self inflicted with hot tobacco ashes, afterwards salt and 
kerosene oil being rubbed in. I taxed "A" with causing his own 
sores, he stoutly denied any malingering practices, and claimed his 
skin lesions were truly leprous, and he could produce witnesses to 
prove it. 

I informed "A" I would use certain measures to decide his 
case. He specially stipulated his non-desire for hypodermic treat- 
ment, but agreed to submit to any other medicines I might see fit 
to use. 

Daily, both the dispensaries at Kalawao and Kalaupapa, offered 
abundant supplies of leprous serum from burn vesicles, (due to 



142 THE PATH OF THE DESTROYER 

thermal anaesthesia) and steam scalds. Leper patients applying for 
remedies to dress these injuries, furnished this fluid from blisters, 
caused by the contact of heat and steam on their hands and feet. 
The loss of sensation, due to various tropho-neuroses, causes the 
lepers to acquire extensive skin lesions due to contact with fire, 
boiling water, and steam. 

These vesicles yield varying amounts of serum, from a tea- 
spoonful to several ounces or more. This blister serum is rich 
in bacilli leprae. 

Hawaiians have a marked dislike for hypodermic injections, 
whether morphine be used or any other drug, fluid or other vehicle. 
I rarely could persuade any Hawaiian to submit to the use of the 
syringe to administer leprous serum. However, in one or two in- 
stances I succeeded in doing so. 

In the month of December, 1884, I took up the case of this 
man "A", and scarified three centers for inoculation with leprous 
serum, one, inner surface left forearm; second, base of neck near 
sternal end of left clavicle; third, left side of abdomen near the 
umbilicus. At all these scarified points leprous serum was thoroughly 
rubbed in with a lancet. The sores on his arms, legs, and body 
were cleansed with warm creoline solution, and afterwards dressed 
with borated vaseline, to each ounce being added 4c.c. of blister 
serum; the patient to dress his sores twice a day, the morning 
dressing being made by my dispenser. 

At the expiration of eight weeks the three points of inoculation 
had healed, were barely visible; some of the old ulcers on the limbs 
and body, had lessened in area, others no improvement, and so the 
case progressed from month to month. One year after inoculation 
there were no signs of leprosy; shortly after I again inoculated two 
foci on the pectoral muscles. 

Up to the year 1895, when "A'' died of acute nephritis, the re- 
sult of alcoholic excesses, no signs of leprosy had showed themselves ; 
a period of over eleven years having elapsed from the time of the 
first inoculation. Three other competent physicians examined "A'' 
in 1895 and pronounced him not a leper. 

"B". Male Hawaiian, 28 years old, lived at Kalaupapa, and 
took care of his mother, who had leprosy for five years. 

This man "B" claimed he had leprosy, on the strength of most 
of the integument of his body, limbs, and face being affected with 
the psoriatic change produced by drinking awa. Patches of tinea 
versicolor were scattered on the neck and dorsum. 

I explained to "B" that his skin trouble was not leprous, and 



THE PATH OF THE DESTROYER 143 

on questioning him he admitted his desire to acquire leprosy, which 
would prevent him being ejected from the Settlement, (as an un- 
desirable, which he was, and lived up to the name), on the death 
of his mother. 

In the month of December, 1884, I scarified a patch of "BV 
skin the size of a quarter dollar, over both lumbar regions, and 
rubbed into these scarified spots a liberal supply of vesicle serum, 
and blood obtained from a young leper woman. 

At the end of two months the inoculated foci showed a little 
discolored skin, and a small blister applied to these inoculated 
spots, by painting cantharides collodion, gave a vesicle fluid devoid 
of any leper bacilli. 

"B" is alive today (1914), left the Settlement in the year 
1902, after a residence of 18 years. He shows no signs of leprosy. 

"C' Male Hawaiian, kokua, aged 24 years, living at Kala- 
wao, with his leper wife. In the same month, and at the same 
time, December, 1884, as "B'\ was inoculated. I performed the 
same operation on "C", inoculating a sore in the web between the 
finger and thumb of the left hand, using blister serum and leprous 
blood ; the w T ound healed at the end of two months, no signs of 
leprosy ever showed themselves. In the year 1908, twenty-four 
years after inoculation, "C" died on Maui of cardiac disease. 

"D." Male Hawaiian, kokua, 31 years of age, living at Kala- 
wao with his sister, a leper of eight years duration. 

At "D's" own request, and to refute his claim of being a leper, 
I inoculated four foci with leprous serum in the month of Decem- 
ber, 1885. The inoculated spots chosen were, inner surface each 
thigh, at base Scarpa's triangle; and both inguinal regions. "D" mar- 
ried a leper woman ; he never developed leprosy, lived 24 years at 
Kalaupapa, and then moved to Honolulu. I occasionally see him 
on the street — he shows no signs of leprosy or any other ailment. 

"E.'' Male Hawaiian, kokua, 25 years old, has a leper wife, 
her disease being of four years' standing. 

"E", because of rheumatic pains, and patches of leucoderma on 
his hands, feet, and nape of the neck claimed he had leprosy. He 
had lived one year in the settlement, and had been examind by 
several physicians, amongst them Dr. Arning, who failed to find 
any bacillus leprae in his tissues or secretions. 

In April 1886, at "E's" own request, I inoculated him over 
the left pectoralis major, immediately above the nipple, the site 
chosen was the seat of extensive pigmentary deposit of tinea versi- 
color. A scarified patch size of half a dollar was thoroughly coated 



144 THE PATH OF THE DESTROYER 

with leprous serum, and saliva furnished by his wife. The scar 
remained visible for six months, and six months later, April, 1887, 
a section of the scar failed to reveal any bacilli. 

At this date I inoculated "E" the second time, with blood and 
blister serum, on the inner surface of his left forearm, midway be- 
tween the elbow and wrist. Fifteen years afterwards in the 
year 1901, "E" showed no signs of leprosy. He had had two 
leper wives, and on the death of the second, left the settlement; 
was pronounced not a leper sixteen years after the first inoculation. 
Since "E" left Molokai, I have lost track of him. 

"F." Male Hawaiian, kokua, 29 years old, his leper wife died 
five years ago, in the year 1880. 

On September 10, 1885, "F'' appeared at, the dispensary at 
Kalawao, and applied for treatment for gonorrhoea, multiple deeply 
excavated soft chancres on the fraenum, and glans penis, double 
inguinal buboes. Under the use of sublimate lotions, a dusting 
powder of boric acid and iodoform, his chancres and gland trouble 
showed improvement, his gonorrhoea slowly yielded to injections of 
1 to 500 zinc chloride solution. 

"F", like all the previous cases I have related, was anxious to 
contract leprosy, and he broached the subject to me several times, 
and requested me to enter his name on the leper list. He was not 
a leper, and I declined to do so. With his permission on two oc- 
casions, at intervals of a month, I administered hypodermic injec- 
tions of 4c.c. of leper blister serum, making the injection intra- 
muscular, into the right buttock. After the second injection, "F" 
refused any more, although no inconvenience, abscess, or tenderness 
followed the two previous ones. It took four months for the buboes 
to heal, and during the later part of the treatment "F" used my 
favorite application in such cases — borated vaseline and 4c.c. of 
blister serum added. Up to January, 1888, "F" never developed 
leprosy; twenty years afterwards, and twenty-three years after, 1 
had given him the injections of leper serum, "F" showed no trace 
of any disease. He had married three leper women, and when the 
last one deceased, he was sent out of the Leper Settlement, charges 
of gambling, and illicit alcohol distilling being registered against 
him. 

"G." Male Hawaiian, kokua, aged 26 years, went to reside 
at the Settlement in 1884, with his sister, a leper. 

"G'' was a confirmed awa drinker, presented a most repulsive 
appearance — purulent opthalmia, thickening and eversion of the 
upper and lower eyelids, bright scarlet conjunctivae, and his entire 



THE PATH OF THE DESTROYER 145 

body a mass of awa scale — patches of rupia formation in places, 
and foul ulcers due to neglect, dirt and foul living, excessive use 
of awa, and salt foods. "G" informed me he was a confirmed leper, 
everyone so stated, and the people of the Leper Settlement thought 
me a very poor doctor because I failed to recognize and accept him 
as a leper, and so list him on the books of the Settlement. He fur- 
ther informed me that my obstinacy and stupidity in not listing 
many other kokuas as lepers, was one of the reasons so few lepers 
called on me for assistance. I let "G's" tirade wear out, they 
were weekly repetitions, and finally I informed him that. I would 
find out shortly, if he was a genuine leper; he was to call around 
next day. 

I shaved, cleaned both axillae, the only apparently non-diseased 
dermal surface remaining, scarified two foci in each axilla on the 
arm and chest surface, and thoroughly rubbed into the scarified 
surfaces about half a teaspoonful of leprous serum; the points of 
inoculation readily healed. 

Twelve months afterwards, sections of the skin of the in- 
oculated spots failed to reveal any bacilli. 

I inoculated this man in May, 1886, and he died a non-leper 
in 1897, eleven years later, from acute alcoholism. 

"H." Male kokua, Caucasian-Hawaiian, 31 years old, segre- 
gated in 1883 as a leper. After residing ten months at Kalawao, 
"H" was pronounced a doubtful case, and was returned to Hono- 
lulu for further examination. There he was declared a non-leper, 
liberated for six months, then re-declared a leper, and again sent 
to Molokai. There are very many cases similar to "H's". The 
same measures, examination, re-examination, arrest, and freedom 
have been carried out. 

The only pronounced signs of leprosy visible on "H" were 
atrophy, paralysis of the interossei muscles of the left hand, wasting 
and paralysis of the forearm extensors, extreme flexing of fingers 
on palm, ectropion with constant lachrymal discharge flowing on to 
the cheeks. The phalanges of the right large toe had been destroyed 
by absorptive caries and necrosis, a large healed ulcer was revealed 
at its favorite seat, the junction of the meta-tarso-phalangeal articu- 
lation, the ball of the toe — a pressure ulcer due to nerve supply 
defects ( Trophoneurosis ) . 

Although past ravages of leprosy were in evidence no bacilli 
could be detected. The case being one of aborted leprosy, and a 
species of leper carrier which I have previously described. 

"H'' requested me to determine if possible the absence or 



146 THE PATH OF THE DESTROYER 

presence of leprosy, and to this end I inoculated him with leper 
serum on a surface about the size of a half dollar, over each lumbar 
region. Six months afterwards a discolored area of skin, correspond- 
ing to the point of inoculation, alone remained to indicate the seat 
of operation. He died in 1901 at Kalaupapa from acute dysentery. 
From the date of inoculation, February, 1887, to the year of his 
decease, no active development of "H's" latent leprosy took place. 

"I." Male Hawaiian, kokua twenty-four years old, his wife a 
Chinese-Hawaiian, a leper, had resided three years at Molokai. 

"I" was affected severely with tertiary syphilis, and had ulcers 
on the anterior tibial surfaces of both legs, necrosis of the nasal 
bones, perforation of both the hard and soft palate. 

It is a repetition all through these cases, kokuas alleging in- 
fection with leprosy, and clamoring for rations granted to lepers. 

Dr. George Fitch, (the same who claimed leprosy to be the 
fourth stage of syphilis, account of which I have written of in 
earlier pages of this book) had treated this kokua "I", giving him 
40 grain doses of potassium iodide, three times daily for months. 
Under this treatment the symptoms, and active lesions of syphilis 
improved, and the large area of ulceration on the legs would heal; 
on the discontinuance of the iodide all the symptoms would break 
out again. 

"I", like all the cases I have previously related, was eager to 
get leprosy, or have his syphilis called leprosy, and expressed his 
desire to undergo any treatment or means which would accomplish 
this end. I therefore decided to try inoculation with leper blister 
serum, always hoping I might succeed in each case, and determine 
the possibility of inoculation. Level with the umbilicus and three 
inches external therefrom, I made two centers of inoculation the 
size of a dollar, in the month of October, 1885. I watched the 
case until 1888, but T' never showed any signs of leprosy — his 
syphilis remained stationary; he died in the year 1897 of locomotor 
ataxia, cerebral hemorrhage being the immediate cause of his death. 
Dr. Oliver, who had watched the case, failed to detect any leprous 
manifestations during the twelve years "I" lived after inoculation. 

"J. ' The tenth, and last male subject on which I performed 
inoculation, was a male Hawaiian kokua, who had resided six years 
at Kalaupapa. 

In January, 1887, at his own request, to decide if he was a 
leper, I inoculated "J" between the shoulder blades, and in the 
lumbar regions ; made three foci, and scarified the wounds deeply, 
well into the deep layers of the skin. Thirteen months afterwards 



THE PATH OF THE DESTROYER 147 

sections of skin from the points of inoculation were examined by 
two physicians, and each of these acting independently of the other, 
pronounced the specimens free of bacilli. 

INOCULATION EXPERIMENTS ON FEMALE KOKUAS. 

"O." A female kokua, Hawaiian, 28 years of age, husband 
three years a leper, and a very bad case. This woman used awa 
to excess, and alcohol also; led a very dissolute life, increasing her 
pocket money by prostitution, in which she was aided and abetted 
by her husband. She had gonorrhoea, with profuse purulent vaginal 
discharge, chancres on the labia and abundance of venereal warts 
scattered about the vulva. 

"O" strenuously insisted she had leprosy, and accused me of 
displaying prejudice against her, and favoring the claims of othei 
kokua women by listing them as lepers. 

This case was an excellent one to determine whether the 
vagina was a permanent seat of the bacillus leprae. Never once 
did I succeed in finding bacilli though all her many consorts were 
lepers. "O" made no fuss or objection to the use of the hypo- 
syringe, and I gave her l.c.c. injections of leper vesicle serum 
ever} 7 month. When her chancres had been cleaned, and disinfected, 
I had her use borated vaseline and leper serum added as described 
in previous cases. 

I watched "O" for two years, but no signs of leprosy ever 
appeared, and shortly afterwards, in the interests of law and order 
she was ejected from the Settlement. I examined "O" for leprosy 
in the year 1898, twelve )ears after the serum injections; she was 
not a leper. 

"P." Hawaiian female kokua, aged 25 years; husband a leper 
five years. This woman was very uncleanly, her skin was scaly — 
patches and crusts covering the entire trunk, thighs, nates, and 
axillae, mostly due to the sarcoptes hominis, or feminae. 

Extensive ulcerated surfaces existed on the nates, and inguinal 
regions, front of the thighs. The groins were the seat of ulcerating 
buboes, both the inguinal, and femoral glands being affected. 

This woman loudly asserted whenever she saw me, that she 
had the "Mai Pake" and clamored for rations, as she and her hus- 
band had to exist on his one ration. Previously this woman had 
been declared a leper, and later on this declaration was revoked, 
and she was listed as a non-leper. 

Under persistent sulphur treatment and tonics "P" improved, 



148 THE PATH OF THE DESTROYER 

much to her own surprise, and she was not pleased with the change 
as the prospect of her rations and general care by the Board of 
Health vanished. 

"P' had profuse and fetid leucorrhoea, cervical catarrh and 
ulcers of the cervix. After these troubles were much relieved, and 
the genital passage free from pus, I repeatedly searched the vaginal 
secretions for bacilli, but never could find them. 

With the patient's consent, I freshened up old chancres of 
both mucous and dermal surfaces of the labia majora, and rubbed 
well into their surfaces, leprous vesicle serum and blood. Four 
times I so inoculated "P" at intervals of four months, the results 
were the same as in previous cases recorded — no leprosy developed, 
from 1887, date of inoculation, to the year 1900 when "P" died 
of fever. Her first husband died in 1890, and then she married a 
second leper husband who survived her. 

"Q." Hawaiian kokua, female, 35 years of age, had lived 
fourteen years at Kalawao, and had four husbands and three chil- 
dren, all of whom, the husbands and children, died of leprosy. 
Her first husband, with whom she had three children, all lepers, 
died a leper. Husband No. 2 was a kokua, developed leprosy two 
years after his marriage to "Q'\ and died shortly afterwards. 
Husband No. 3, was also a clean kokua. One year after his marriage 
to "Q", he became a leper and died three years after the disease 
showed itself. 

"Q" was petite, and very comely and graceful, remained a 
widow for four weeks, when husband No. 4, a mere youth came on 
the scene. Within one year he developed leprosy and died eighteen 
months afterwards. No children were born with her three latter 
husbands. 

"Q" decided she had had enough husbands, and refused the 
advances of all other suitors. She did washing, sewing, hat making 
and mat making for a living. 

Naturally the speedy way in which all the husbands of "Q" 
became lepers caused considerable comment and gossip ; she was 
examined by many physicians, and all pronounced her not a leper. 
"Q" was very clean and neat in person, her skin was free from 
blemish. I searched her nasal secretion, the saliva, the blood, its 
serum, faeces, and vaginal secretion, and had the same examined 
by other physicians; no bacillus leprae could be detected. 

At one period of my residence at Kalawao, I had difficulty in 
getting my wearing apparel washed and laundried, and being in 
considerable pilikia, I engaged "Q" to wash for me, my usual 



THE PATH OF THE DESTROYER 149 

washerwoman having died, and as a physician at the Settlement 
requires no elegant starched bosom shirts or Beau Brummel clothes, 
a very modest wardrobe suffices. 

In due course, "Q" showed up all ready to begin washing, 
and scarcely had she rolled up her sleeves, when Father Damien 
came racing along to my house, and begged and implored me not 
to employ "Q," offering to obtain the services of another kokua 
washerwoman. 

Father Damien recounted all "Q's" past history, and how 
husband after husband had fallen victims to leprosy, all of which 1 
knew. 

I did not discharge "Q," as I felt no fear of getting leprosy 
through her laundry work for me; she was clean and neat, neither 
drank alcohol, nor smoked, and was no doubt immune to leprosy. 

I may say here that Father Damien was most careless and 
reckless in his associations with lepers, seemed perfectly indifferent 
as to whether he fell a victim to leprosy or not. I repeatedly 
scolded and rebuked him for having leper cooks and servants, 
he turned a deaf ear to all my remonstrances; yet he displayed 
genuine concern and alarm when he thought I was taking an undue 
risk, by employing "Q" to wash my clothes. 

This woman "Q'' had fears that she would be deported from 
Kalawao. During her fourteen years of residence all her friends 
and relations outside had died, and she regarded herself as a home- 
less outcast, if she had to remove from the Settlement. 

I regarded "Q" as immune, as are numbers of the Hawaiian 
race, but immunity cannot be definitely determined until pro- 
longed contact with leprosy has taken place. 

"Q," apparently one of the Hawaiian race, lacked the thick 
lips, wide nostrils, and broad nose from tip to base, of the pure 
Hawaiian ; her type was East Indian and Hawaiian, and I pon- 
dered over the idea, wondering whether some previous Indian 
ancestor had not conferred immunity on "Q," which in part ac- 
countea for her resistance to infection. 

"Q" was perfectly willing to acquire leprosy, if such a condi- 
tion could be brought about; she was perfectly indifferent as to 
the ultimate result — she would gain her chief desire, life-long 
residence, food and lodging. I acceded to her importuning and 
on two occasions at intervals of four months, I injected 2 c. c. of 
leprous vesicle fluid into the lumbar regions, 1 c. c. into each 
flank. The second injection, later on, was made between the 
shoulder blades, and also into the abdominal muscles below the ribs, 
in the mid-axillary line. Of the many instances in which I injected 



150 THE PATH OF THE DESTROYER 

this vesicle serum, "Q" was the only case where marked reaction 
occurred; headache, chills, fever temperature 103.6, bodily pains, 
nausea, and profuse sweating, all followed the injections for four 
succeeding days. This reaction scared "Q," she thought I pro- 
posed to kill her right off, and any further injections were declined. 

"Q" lived fifteen years after being inoculated, but no leprosy 
ever appeared ; she had lived twenty-nine years in contact with the 
disease. 

"R" Kokua, Chinese-Hawaiian woman, aged twenty-four years, 
husband Chinese-Hawaiian, a leper, had resided two years at Kala- 
wao, since spring of the year 1883. 

In March, 1885, "R ' came to the dispensary for relief from 
skin troubles, consisting of eczema impetigo, scabies, multiple ul- 
cers of legs, abundance of warty condylomatous growths on both 
labia and round the anus — ulcerating inguinal buboes. 

"R" claimed she had leprosy and pala or syphilis, and had 
been so informed by Dr. George Fitch, who had also treated her. 

I could not satisfy myself that her skin and other troubles 
were due to syphilis, so used no antisyphilitic remedies. 

"R's" genital passage was free from disease and from bacilli, 
which I was always seeking in order to confirm or eliminate the 
vagina as a permanent seat of the bacillus leprae. 

Creoline solutions and sulphurated potash baths worked im- 
provement in "R's" skin troubles, and later the large ulcers were 
dressed daily at. the dispensary with borated vasaline and leprous 
vesicle fluid added. This woman, anxious to obtain rations, wished 
to be listed as a leper. After three months' treatment "R" was 
much improved, I afterwards gave her 30 grains of potassium 
iodide with iron potassium tartrate, her ulcers and other troubles 
changed for the better as long as treatment was kept up ; ceasing 
to use the remedies, a relapse immediately took place. I lost 
sight of "R" and forgot all about her case. 

When warm medicated baths were installed at the Settlement 
the lepers using them derived immediate benefit, and their general 
health and comfort were greatly improved. "R'' took medicated 
baths twice a day, and when I saw her last in the year 1898, she 
had to remind me who she was, so great was the change in her 
appearance, that I failed to recognize her. Her syphilis was 
practically eliminated, if she ever had it, and her freedom from 
leprosy was only too apparent. 

"R's" first hubsand had died ; afterwards she married a sec- 
ond leper husband, with whom she had two children, both free 
from leprosy. 



THE PATH OF THE DESTROYER 151 

"S," Hawaiian female, twenty-six years of age, born at Kalau- 
papa on holdings, homesteads outside the control of the Board of 
Health, for all purposes she was one of the Leper Settlement resi- 
dents. These original residents (kamaainas) continued to live 
unmolested alongside the leper homes for twenty-nine years, then 
the holdings were condemned and the dwellers thereon expelled 
from the Leper Reservation. "S" was one of these kamaainas. 
None of them ever developed leprosy; there were 38 or 39 of them, 
male and female. "S" married a kokua, he subsequently contracted 
leprosy four years after their marriage. They had no children. 
"S" claimed to be a leper on very poor evidence; she, like most 
other kokuas, had no desire to leave Kalaupapa. Her hands and 
feet were devoid of sensation, but there were no changes in the 
skin, muscular structure, or blood vessels. "S" had gonorrhoea, 
cystitis, ovarian and uterine disease, was addicted to taking alcohol 
in excess (the home-made kind), and these drunken debauches 
would be continued for days. 

"S'' had been repeatedly examined in Honolulu for leprosy, 
the decision always being not a leper. She used to be a frequent 
visitor to the dispensary at Kalaupapa. I inoculated her on dif- 
ferent occasions with blood and serum obtained from facial le- 
promae of her husband, on the arms and back at intervals of four 
months. These inoculations were made in November, 1886, and 
when she was examined by a medical commission nine years after- 
wards, in the year 1895, no leprosy was in evidence, and she was 
ordered deported with the other kuleana holders on the condem- 
nation of their homesteads. 

In the year 1904 "S" was not a leper. She had lived over 
thirty-five years altogether, in contact with leprosy. 

Neither gonorrhoea nor syphilis affect leprosy; each runs its 
course irrespective of the other. 

The record of FIFTEEN inoculations of kokuas with leprous 
fluids shows every case was a FAILURE and produced no results. 

A CELEBRATED CASE 

Within the past twenty-five years, two events connected with 
the history of leprosy caused the eyes of the world to become fo- 
cused on Hawaii, gave these islands prominent and unenviable 
notoriety, and caused them to be regarded as a focus of endemic 
contagious leprosy. 



152 THE PATH OF THE DESTROYER 

First, the successful inoculation or alleged inoculation of Ke- 
anu, the Hawaiian murderer. 

Second, the infection of Father Damien, Catholic priest at 
the Leper Settlement, who fell a victim to nodular leprosy; together 
with the rapid progress and fatal issue of his disease. 

(a) The case of Keanu fails to carry conviction on the ab- 
solute inoculability of leprosy, because the operation performed on 
him was not one of legitimate inoculation; a better definition would 
be transplantation of leprous flesh. 

(b) The infection of Father Damien illustrates what may 
happen to anyone who is careless and imprudent in contact with a 
contagious disease, and cannot be construed to indicate that leprosy 
is positively contagious to all contacts. 

I will now give a brief history of the case of Keanu, the 
Hawaiian murderer, whose death sentence was commuted to im- 
prisonment for life, with the added proviso "that he submit to in- 
oculation with leprosy." Under no circumstances was he to be 
pardoned and given his freedom, as has been stated in certain 
mainland publications. 

KEANU, THE MURDERER 

In the gray dawn of the morning of February 16, 1884, on 
a lonely and unfrequented part of the Kohala-Waimea road in 
the district of Kohala, island of Hawaii, Keanu, a Hawaiian, club- 
bed, beat in the skull with a wooden bludgeon, and murdered 
Charlie, a Japanese of diminutive stature and feeble strength. This 
Japanese with the "haole" name of Charlie, was married to Ka- 
maka, a Hawaiian woman, and the illicit and clandestine liason 
between Kamaka and Keanu led to the murder. 

Keanu determined to get the Japanese out of his way, and 
he premeditatedly murdered him under the circumstances before 
stated, purposely waylaying the man, addressed words of welcome 
to him, pretending friendship when he encountered the Japanese, 
he threw him off his guard, assaulted and beat him to death with- 
out provocation. 

In due course the body of the murdered man was discovered; 
suspicion pointed to Keanu, and Kamaka gave damaging evidence 
against her paramour. 

Keanu attempted to prove an alibi, asked for change of venue 
from the Hilo Circuit, which was granted May 8, 1884, by 



THE PATH OF THE DESTROYER 153 

Judge Lawrence McCully, and the case was transferred to the 
July term of the circuit court at Honolulu. 

" Before Chief Justice A. F. Judd on July 9, 1884, Keanu 
was arraigned for murder in the first degree. He pleaded not 
guilty, his counsel being Kaulukou and Poepoe. 

Paul Neuman, attorney-general, and Austin Whiting, deputy 
attorney-general, appeared for the crown. 

The trial occupied two days, the direct and circumstantial evi- 
dence strongly implicating Keanu. The jury brought in a verdict 
of guilty as charged — murder in the first degree. 

Keanu's counsel applied for a new trial, advancing the usual 
well-worn pleas that the verdict was contrary to the law and 
evidence. 

Five days after the jury's verdict had been rendered; on July 
16, 1884, the Supreme Court sat and heard the arguments of 
Keanu's counsel for a new trial. 

Under the judicial procedure then in force, the trial judge 
also sat as a reviewing judge, together with the other associate 
judges of the Supreme Court. 

At the hearing of Keanu's appeal for a new trial, Chief 
Justice A. F. Judd, Associate Justice Lawrence McCully, and 
Associate Justice J. J. Austin, occupied the bench. 

Two days after the hearing of the evidence for a new trial 
the Supreme Court, on July 18, 1884, unanimously denied the mo- 
tion, and Keanu was sentenced to be hung on the last Tuesday of 
October (28), 1884. 

Chief Justice A. F. Judd was an excellent and competent 
Hawaiian scholar, and for Keanu, if he had the slightest possibility 
of proving his innocence, no better judge could have sat on the 
bench to aid him than the late Albert Francis Judd. 

Keanu, at the time of his sentence to death was forty-eight 
years old, his physique was massive, and his weight at least 250 
pounds, broad-shouldered, and of erect carriage, about 5 feet 10 
inches tall — he w T as a formidable antagonist for the average man 
to tackle. 

I have not been able to get access to all the documents in the 
case, but I was informed by the late Dr. George Trousseau, "that 
the Board of Health petitioned the late King Kalakaua's Privy 
Council of State to commute Keanu's death sentence to life im- 
prisonment, and for the advancement of science he (Keanu) was 
to submit to inoculation with leprosy." The Privy Council acceded 
to the petition and its terms. 



154 THE PATH OF THE DESTROYER 

INOCULATION OF KEANU 

Keanu was confined in Oahu jail, and on September 30, 1884, 
he gave his written consent to Dr. Edward Arning to inoculate 
him with leprosy. 

Dr. Arning excised a leproma, about the size of a small hen's 
egg, from the cheek of a young leper girl and transplanted and 
embedded this leprous flesh into an incision, which laid bare the 
belly of the supinator radii longus muscle of Keanu's right fore- 
arm; the leprous tissue or leproma was sutured in position. 

Twenty-five months after this operation, October, 1886, 
Keanu showed the maculation of nodular leprosy all over his 
body, the nerves and lymphatic glands near the seat of the wound 
also showed implication. The infection in the various selective 
seats of the body peculiar to leprosy became apparent (ear lobes, 
helix, cheeks, forehead, supra-orbital alopecia, etc.), in the year 
1887; in the fall of that year, some three years after inoculation, 
Keanu was a confirmed leper, apparent to all the inmates of the 
jail, wardens and prisoners. 

I examined Keanu in February, 1888, at the request of the 
United States Minister, G. W. Merrill, at the Oahu jail; the 
details of this examination were forwarded to Washington. 

All through the year 1888 Keanu's leprosy progressed rapidly. 
He became a menace to the prisoners in the jail; no proper ac- 
commodation for him existed in the hospital of the prison, there- 
fore it was determined to remove him to the Leper Settlement on 
Molokai, where all facilities existed for the care of lepers. 

Keanu was transferred to Molokai, landed at Kalaupapa Feb- 
ruary 6, 1889, and died at Kalawao, November 18, 1892, eight 
years and fifty days after his so-called inoculation with leprous tis- 
sue; he had then reached the age of fifty-six years. 

Twenty-five years ago, the average duration of life of a Ha- 
waiian affected with nodular leprosy was about eight to ten years, 
so that Keanu's tenure of life was about that of the average leper. 

Dr. Swift, who resided four years (1888-1892) at the Molo- 
kai Leper Settlement, made known the fact that Keanu's relatives 
were affected with leprosy, and that he (Keanu) had lived in 
the same house with these leper relatives. This discovery raised 
the question whether Keanu was a leper previous to his inoculation. 

Most old residents of Hawaii know well that the Hawaiian 
family relations are described in a very loose and careless fashion 
by the Hawaiians themselves; such appellatives as cousin-brother, 
cousin-sister, brother-cousin, and sister-cousin mean what? Even 



THE PATH OF THE DESTROYER 155 

today a man frequently has plural wives, he will live and co- 
habit with his married wife and her sister; the reverse — one wife 
with two husbands — is even more common. Punalua is the techni- 
cal term used in these cases. These intimate relations are not pe- 
culiar to Hawaii, they exist in many countries. 

In the case of Keanu, his maternal cousins, so-called, had 
leprosy before he did, and they may have been in reality his 
own brothers and sisters, viewing the matter in the light of the 
peculiarly loose and bewildering family relations and associations 
maintained in Hawaii. 

All the data and features connected with Keanu's case can- 
not determine the question of the inoculability of leprosy in man. 
By no such possible method could the average person accidentally 
become infected with leprosy, similar to the measures pursued in 
Keanu's case. 

Transplanting and imbedding leprous tissue into the healthy 
person cannot by any manner of means be termed inoculation, which 
I have defined at the beginning of this chapter; no argument can 
convince me that it 5s. It is an extraordinary method of infection. 

Transplant tubercular glands, scirrhus, epithelioma in bulk to 
any non-immune person and that person will probably become in- 
fected; such an experiment is of no value to determine the average 
every-day infection or non-infection of mankind with any of these 
diseases. The same remarks apply to the Keanu experiment, which 
was unique, extraordinary, but one way or the other could not 
possibly meet the issues that face us on the inoculation question. 

In the face of all my own experiments, those of others, and 
my general knowledge of the cause of the spread of leprosy, I 
assert and claim, as I have done previously at the beginning of this 
chapter, "that leprosy cannot be inoculated in man or animals on 
any dermal surface by ordinary methods. I also assert that the 
chief cause of the spread of leprosy is not by inoculation/' 

There are fair indications that certain essential conditions are 
necessary for a successful invasion of man by the bacillus leprae. 

Preliminary. — (a) Receptive System. 
Preliminary. — (b) Mucous Surface. 

Preliminary. — (c) Presence of a FERMENT at point of en- 
trance to the Human System. 
Preliminary. — (d) Presence of LEPROGEN in the tissues. 

The bacillus leprae possibly possesses a certain inherent power 
to extract from the tissues of man a fermentogen, or a substance 



156 THE PATH OF THE DESTROYER 

which may be converted into a ferment, which enables it to exist 
and develop primarily. 

This said ferment later causes the tissues to liberate LEPRO- 
GEN, a pabulum which MAN alone possesses; it is presumably 
absent from the tissues af animals, hence they are generally im- 
mune to infection with leprosy. 

It has appeared to me for many years, that the secrets of the 
cause and production of leprosy in the human system cannot be 
revealed through hemal investigation, on which workers have spent 
years and years of study without results, which ought to convince 
them of the fruitlessness of continuing along these lines, in attempt- 
ing to prove leprosy as a disease carried in the blood, hence inoc- 
ulable. A greater prospect of success lies along other paths, which 
I advocate, to wit: the secretions and fluids of the alimentary 
canal. 

I am in possession of certain data bearing on alleged inocu- 

ation, but utterly irrelevant and immaterial to the subject, these 

data I have gained during my many years of investigation. Some 

of the facts, so-called, are startling, but in a book of this nature, 

intended for the general reader, are unprintable without shocking 

public morals. 

* * * 

To end this chapter I repeat the very significant fact that 
fresh areas of infection cannot be produced in the incipient leper, 
nor when the case is advanced. Fresh areas of infection can be 
started in the syphilitic, in the primary and secondary stages of the 
disease, by inoculation, and also in tuberculosis in animals. 

I have made over one hundred attempts to inoculate new areas 
of the disease, in LEPROSY, in mild cases of the nodular form, 
and never once succeeded. Absolute proof of the inoculability of 
the disease has yet to be demonstrated. 



CHAPTER IV. 

IMMUNITY 

Immunity, the condition of being immune, is security against 
any particular disease, and differs from susceptibility to the extent 
only of being less susceptible. 

The various conditions of immunity are as follows: 

1. Natural Immunity, the immunity with which any person 
is born. 

2. Acquired immunity can be acquired in various ways. 

3. Active Immunity, conferred after recovery from an infec- 
tious disease, such as measles, small-pox, scarlet fever; one attack 
is usually preventive of a second. 

4. Actual Immunity is conferred after an attack and recovery 
from a contagious disease. 

5. Immunity by Inoculation, successful inoculation of vaccinal 
virus as a protective against small-pox, a non-permanent immunity, 
requires a repetition of the operation after a varying lapse of years. 

6. Passive Immunity, inoculation with an antitoxin or an at- 
tenuated virus. It yields the same results as when the bacteria 
themselves are used. 

7. Inherited Immunity. The foetus in utero receives an im- 
munity from the mother, being subject to the same disease which 
infected that parent. 

8. Racial Immunity. Natural immunity possessed by race or 
group of people. 

It is questionable whether actual immunity recovery after an 
attack of contagious disease, could not be applied to the abortive 
changes in nerve leprosy, the disease ceasing to become active; this 
conservative action is without doubt due to some toxin liberated in 
the tissues of the body which heads off, starves, or kills the bacillus 
leprae. 

Susceptibility to disease is present in all cases, varies amongst 
different races of men. 

Race susceptibility consists of three forms: natural, acquired, 
and inherited ; it is very doubtful if any of these conditions are 
applicable to leprosy. 

BACTERIAL INFECTION 

The infective agent must be possessed of pathogenic properties, 
such as the status of the bacillus leprae to man, but not to animals. 



158 THE PATH OF THE DESTROY ER 

In man the parasitic bacteria cause disease, and generate toxic 
products in the system called toxins. Each toxin must accumulate 
a certain degree of strength and quantity in the system, and the 
amount of toxin that each individual will succumb to, varies ac- 
cording to his resisting powers, be they great or small. 

The incubative period of any disease is determined as to its 
length or brevity, by the presence in the system of a certain definite 
amount of its toxin, in order to sustain it and enable it to do effec- 
tive work. 

The bacilli of leprosy locally cause mechanical obstruction in 
the blood vessels, and gradually bring about breaking down and 
destruction of tissues. During the recurrent attacks of leprous 
fever the infective toxin enters the blood, and is the cause of the 
various phenomena which ensue during the course of the fever. 

This toxin seems to be excreted by the bacilli, in order to aid 
them to overcome certain opposing conditions in the system of the 
leper. 

MOST PERSONS ARE IMMUNE TO LEPROSY 

From the strikingly visible evidence put before us in Hawaii, 
it is absolutely safe to conclude that most people are immune to 
leprosy, save the Hawaiian, who is essentially lacking, but the rem- 
nant of the race is becoming more immune every day. 

During the years 1888 to 1902, segregation was at its maxi- 
mum, and the prevalence of leprosy amongst the Hawaiian people 
amounted to almost 4% of the population. Due to increasing im- 
munity, continuous and more effective segregation, the percentage 
of leprosy for the year 1915 has fallen to 1^4%. 

LUX IN TENEBRIS 

It is quite a lengthy period of years from the quaint and 
crude description furnished us by Atreya of the Kushta, leprosy, 
2000 B. C, to the late sixties of the nineteenth century, when Dr. 
Gerhard Armauer Hansen, Norwegian physician, working with in- 
domitable courage, under most adverse conditions, was able to 
drag from the shades of darkness and demonstrate to the world, 
"that the tissues of the leper contained a microscopic vegetable para- 
site, in form a bacillus," which bears the name today of bacillus 
leprae of Hansen. 

Dr. Hansen was born in the year 1841, and died in 1912. 

Dr. Albert Neisser of Breslau, Germany, further investigated 
Hansen's Bacillus, and with improved methods of staining, and the 




DR. GERHARD ARMAUER HANSEN, OF BERGEN, NORWAY 

He discovered the Bacillus of Leprosy, A. D. 1868, 
in the twenty-seventh year of his age. 



Born 1841. Died 1912. 



160 THE PATH OF THE DESTROY ER 

oil immersion microscopic lens, was able to corroborate Hansen's dis- 
covery, and the presence of the bacillus always in that form, ab- 
sence of spores, and its non-motile character. Today, with bac- 
teriology, founded on a firm basis, improvement in staining methods 
and microscopic construction, it can be truly said, "we have got the 
bacillus leprae, or leper flea popularly called," and it rarely es- 
capes being found in the tissues and secretions of the leper. 

Dr. Hansen had the advantage of having a vast field of lep- 
rosy to work amongst in the leper hospitals in and around Bergen, 
Norway. 

The veteran leprologists Dr. Daniel Cornelius Danielssen 
(1815-1894), and Dr. Carl Wilhelm Boeck (1808-1875), were 
his coadjutors. 

About the year 1868, Hansen found the leper bacillus, con- 
tinuous investigation always gave him the same results, and in the 
year 1872 he showed his specimens to other bacteriologists; these, 
working independently, reached the same conclusion as Hansen, 
finding the bacillus always present in leper tissues. 

Some forty years ago, 1874, the bacillus leprae was unani- 
mously accepted as being peculiar to leprosy; it was invariably 
found in various tissues of the confirmed leper. The genius of 
Hansen made plain a subject upon which absolutely nothing was 
known, and which had been an enigma to physicians and philoso- 
phers for more or less 5,000 years. 

In Biblical times, from the Book of Leviticus, we learn noth- 
ing of the cause or treatment of true leprosy, and so on to the be- 
ginning of the Christian era. 

From about. 25 A. D. to 33 A. D., the active years of the 
miraculous work of our Lord, lepers were cured, but nothing per- 
manent was revealed to mankind. The cure of the disease and its 
cause remained as great a mystery as ever. 

From the death of Christ, all through the early years of the 
subsequent Christian era, to the first thousand years after this 
event, history is silent on any discoveries about leprosy. 

The disease was known, must have been latent, before spreading 
all over Europe in the middle centuries. Through all these years 
no advance in the scientific knowledge of the disease was made, until 
the persevering Hansen discovered the bacillus, and thereby threw 
the first beams of light on a subject hidden in the densest darkness 
for fifty centuries. 

I have yet to learn if Dr. Hansen ever received any reward 
for his splendid discovery. 

Even that great discoverer, the German physician, Dr. Robert 



THE PATH OF THE DESTROYER 161 

Koch (1843-1910), of bacillus tuberculosis fame, I believe also 
went without reward ; he received no letters patent of royal titles, 
or grants of money or lands — prizes often handed out to civilians 
for various achievements not a fraction of the value to humanity 
compared with the work of these two scientific physicians, whose 
discoveries have benefited all peoples at no cost to any government 
or the public. 

The years of tedious work necessary to reach the climax of 
the discovery of these two bacilli, lepra and tuberculosis, were given 
freely and voluntarily for the good of all PEOPLES, by both Dr. 
Hansen and Dr. Koch ; their reward, except for the fame and 
publicity accruing to them, must come in the "Hereafter." 

HANSEN'S BACILLUS LEPRAE 

In Hawaii this bacillus shows some slight modification from 
the European and Indian forms. 

The bacillus leprae is smaller, shorter and much more slender 
than its ally the bacillus tuberculosis, which it much resembles; it 
is apparently immotile, has pointed or clubbed ends. 

The average measurements of forty specimens of bacilli, was 
3 m. (microns or micro-millimeters) in length and .4 m. (microns) 
in width ; these specimens were taken from forty lepers, eighteen to 
thirty years of age, of good development, and a medium progress 
of the disease had been reached. A micron equals ^fUo oi an 
inch. The bacillus leprae is easily stained by Fuchsin and Gram's 
solution; it is also more easily decolorized by the acid and alcohol 
washings used in the staining process, than the bacillus tuberculosis. 

The bacillus leprae in Hawaii differs from the Indian speci- 
mens in the thickness of the cell wall, and the diameter is also 
greater. The granular contents of the cell are more pronounced, 
and these class of bacilli are in a large majority; the homogeneous 
appearance of the cell contents is very indistinct, the staining of 
these contents is more difficult. 

The presence of spores and flagellae is negative ; there is gen- 
erally a preponderance in the microscopic field of the granular or 
old type of bacilli, as they might be termed. The homogenous 
bacilli are not largely represented ; they are possibly young bacilli 
or those of recent development. 

The ordinary Fuchsin stain does not show up the bacillus in 
Hawaii as it does in the Indian and European varieties. Other 
observers have noted this ; there is a blurred appearance, due prob- 



162 THE PATH OF THE DESTROYER 

ably to a higher albumin content of the cell wall, which prevents 
and lessens the permeability of the stain. 

Bacteria multiply and increase through segmentation or fission ; 
the type of bacteria called bacilli elongates, usually about its center, 
the cell wall becomes puckered or indented, gradually a septum or 
division is thrown across the width of the cell connecting its oppo- 
site walls; this septum divides the cell into two parts, forming each 
a separate cell or parent, successive divisions later taking place. The 
new cells may exist separately or form part of a group. 

In order to protect their contents, the cell walls of bacteria are 
generally remarkably resistant and tenacious. They resist physical 
and chemical destruction in a remarkable manner, and many spores 
and bacteria resist a temperature of the boiling point, 212° Fahr., 
for hours before they succumb. 

The bacillus leprae seems not to possess intense resisting 
powers, all evidence tending to prove that it is of feeble vitality, 
and is easily rendered inert and sterile by changes of temperature 
and unsuitable location, and cannot thrive and flourish under the 
conditions which enable the bacillus tuberculosis to exist. 

THE BACILLUS OF LEPROSY 

Organs, tissues, secretions, etc., where bacilli are FOUND, 

although there are many variations in its presence. 

Liver. Jejunum mucosae. Spinal cord. 

Spleen. Ileum mucosae. Saliva. 

Lungs. Colon mucosae. Nasal secretion. 

Kidney. Peyers patches. Sputum. 

Testicle, at times. Solitary glands. Faeces. 

Ovary, at times. Lymphatic glands. Nodules. 

Tonsils. Sebaceous glands. Milk, at times. 

Salivary glands. Skin, superficial layer. Thermal blebs. 

Sublingual glands. Skin, deep layer. Mouth ulcers. 

Nerve sheaths. Lymphatics. Tongue ulcers. 

BACILLUS NOT FOUND 

Blood, except in leprous fever. Placenta. 

Urine. Uterus. 

Tears, variable. Semen, variable. 

Milk of nursing mother. Sweat. 

Menstrual blood. Brain. 

Lochia. . FOETUS. 



THE PATH OF THE DESTROY ER 163 

Bacillaemia, the presence of the bacilli in the blood, occurs 
during the febrile attacks in leprosy. 

The organs, tissues and secretions of two still-born children, 
both sets of parents being lepers, presented NO bacilli. 

Leprosy is rare before the fifth year of age; the youngest 
case I know of occurred at three years and two months. The 
parents were not lepers, but the child was given to an aunt to 
bring up shortly after its birth. This woman was a leper, and 
the food of the infant was pap of sweet potato chewed and churned 
up in the mouth of the leprous aunt. 

The lymphatics are permanent habitats of leprous bacilli, the 
thoracic duct contains almost invariably large numbers, and the 
mesenteric glands. 

The blood is no permanent habitat of the bacillus leprae. 



CHAPTER V. 

CONTAGION, ETC. 

The entire history of the spread of leprosy in Europe neces- 
sarily leads to the conclusion, that it must have been contagious 
on that continent, otherwise we are at a loss to explain the wide 
extent of the disease and its centuries of prevalence. 

In the early years of the outbreak of leprosy in Europe, the 
housing, social customs, contact and many other conditions favor- 
able for spreading the disease, resembled the situation prevailing 
in Hawaii until a decade or two ago. 

Thirty years of experience with leprosy in the Hawaiian Islands 
has convinced me that they afford a strikingly rich, virgin field for 
observation and investigation. 

The most promiscuous and freest commingling of the leper and 
the healthy has taken place, and the result attained has been, and 
is strikingly in evidence. The number of lepers in former years 
was as high as four per cent amongst the aboriginal race, a higher 
rate than can be found amongst the people of any other country. 

The contagium of leprosy, that specific virus or material in 
which its infective power resides (the bacillus leprae) is mild, and 
has no such virulent properties as the contagium of tuberculosis 
(the bacillus tuberculosis). Did this high degree of contagion 
exist in leprosy the Hawaiian race would be doomed to speedy 
extinction. 

The columns of my daily records, for any two years, show re- 
sults almost identical in the three diseases I have selected, to ap- 
proximate the relative degree of prevalence of each : 

Tuberculosis One hundred and ten cases. 
Syphilis Thirty-four cases. 

Leprosy Nineteen cases. 

Prevalence of a disease affords some clue to its contagiousness, 
therefore, — Leprosy in prevalence and infective power would aver- 
age 1 9-10. Syphilis in prevalence and infective power would aver- 
age 3 2/5. Tuberculosis in prevalence and infective power would 
average 1 1 . 

For these approximate figures the Hawaiian race has been 
taken solely for comparison. 



Leprosy is limitedly CONTAGIOUS to the CARELESS 



THE PATH OF THE DESTROYER 



165 



contact with the disease, and is practically NON-CONTAGIOUS 
to the CAREFUL. 

I have stated before, that in the conjugal relation the infection 
of the healthy consort even in tuberculosis is uncertain, and in 
leprosy is much more so. 

Although Hawaii is, and has been an active center of endemic 
leprosy, the following figures show that a large majority of the 
Hawaiian race are free from the disease. 



EIGHT CENSUS PERIODS HAWAIIANS. 



1866 | 1872 | 1878 | 1884 | 1890 | 1896 j 1900 
58,765 | 51,531 | 47,508 | 44,228 | 40,622 | 39,504 | 37,635 


1910 

38,547 


Average 
44,792 


SEGREGATED LEPERS 
HAWAIIANS 






II 1 1 1 1 1 Total 
105 | 536 777 | 680 1,179 | 1,100 | 957 | 658 | 5,992 



Average number of lepers at each census period 749 

It has never been possible to segregate all the lepers. Num- 
bers have hidden themselves, or have been concealed by their friends, 
many have died in the early stages of the disease from other 
complications. The following figures give a fair estimate of the 
number of lepers. 

SEGREGATED 

From the year 1866 to the year 1886 — 20 years 3,119 

From the year 1886 to the year 1906 — 20 years 3,313 

From the year 1906 to Jan. 1, 1915— 9 years 785 



7,217 



UNSEGREGATED 



From the year 1835 to the year 1865 — 30 years 686 

From the year 1866 to Jan. 1, 1910—44 years 1,793 



2,479 



(Approximate estimate.) YEARLY AVERAGE, 33.50 
Calculated on a ^2 of 1% basis of the population at 
census period, and deduced from continuous questioning 
of the inhabitants of all the large islands, and from my 
own personal travels and investigations during 28 years. 
APPROXIMATE TOTAL OF ALL LEPERS... 9,696 



166 THE PATH OF THE DESTROYER 

The records kept of segregation, both at Kalihi and the Leper 
Settlement, in the early periods of its enforcement, are very im- 
perfect; as a matter of fact the Schooner "Warwick'', and many 
other vessels, landed lepers from Maui and Hawaii direct at 
Kalaupapa, whose names were never entered on the books of the 
Settlement. I repeatedly discovered serious errors and discrepancies 
during the period of years between 1868 and 1877. 

Shipments of lepers direct from Honolulu were duly entered, 
and tallied on the whole, with the books kept in Honolulu by the 
late Deputy Marshal Dayton, and the chief clerk of the Interior 
department, John Hassinger, also deceased. 

The segregation of lepers has been irregular, spasmodic and 
efficient only at certain periods. 

This is only too plainly evident in the testimony supplied by 
the yearly number of lepers segregated, as per following figures, 
which indicate activity and slackness, alternately; depending in the 
main on election or non-election years. 

Year Total Admissions 
1866 . . .. 141 

1869 . 190 

1870 57 

1873 415 

1876 75 

1878 209 

1880 51 

1883 300 

1886 43 

1888 571 

1889 307 

1892 105 

1893 209 

1899 61 

The efforts to stamp out leprosy by segregation have taken on 
the status of a political football, the party in power being assailed 
by the outs, who return the attack in kind. 

Both political parties have been offenders, using the care and 
segregation of lepers as a target or a cudgel, depending on the 
state of the case. 

The segregation law hits severely the Hawaiian race, the mem- 
bers of that race furnishing nearly all the lepers. I have stated 
before, the Hawaiians are in the main opposed to segregation and 
look at the enforcing of the law as a tyrannical act. 



THE PATH OF THE DESTROYER 167 

Money has the same power in Hawaii as elsewhere; position 
and influence also has its weight, and it has been alleged immunity 
from arrest and deportation to Molokai can be purchased, but no 
proofs of this allegation have been furnished. 

The Hawaiians have the majority of votes, and to placate 
voters and gain their votes the enforcement of the segregation law 
has been purposely allowed to lapse temporarily; it is here where 
the advantages of Federal control would become manifest; then we 
would have efficient segregation; not as in the past, with leaks and 
weak spots glaringly in evidence. 

All the reasons I have set forth above and in a previous 
chapter, will give ample information to the outside world why 
segregation of lepers has not made a better showing, and is my 
reply to the oft-asked question from various governments: Why 
does leprosy keep up its activity in the face of decades of segre- 
gation? 

All of the foregoing statements and figures, although they may 
be open to criticism, should go far to convince any unprejudiced 
person that the Hawaiian people are far from being a race of 
lepers, as has been thoughtlessly and unjustly alleged by some, on 
a very superficial knowledge. The same aspersion on the status 
of the Hawaiian people in regard to the prevalence of syphilis has 
also been made. This is also unjust and untrue; my experience 
and that of many other physicians has been that syphilis affects the 
Hawaiians very mildly, and prevails in a moderate degree only. 

The free and close intimacy maintained by the Hawaiian peo- 
ple in contact with lepers, and the resulting prevalence of leprosy, 
corroborates the statement of the late Dr. Tilbury Fox, famous ex- 
pert on skin diseases: 

"It is in those places where leprosy is on the increase that the 
freest intermingling of the leprous and non-leprous takes place.'' 

Dr. McNamara's statement on the condition of the leper in 
India, shows a marked contrast to the attitude assumed in Hawaii 
towards the leper. 

"Although lepers move about amongst their countrymen, they 
are isolated from them. Whoever saw a healthy native touch, much 
less eat, with one affected with leprosy? 

"In many parts of India, the fact of admitting a leper to a 
general hospital is sufficient to drive every other person out of it.'' 

It is reasonable to suppose that a person, susceptible to leprosy, 
can re-infect himself every time he comes in contact with a leper. 
For example, eating three meals a day with him — such a case 
would also show more rapid progress than one not so frequently 



168 THE PATH OF THE DESTROYER 

infected; it also becomes apparent that we may be able to account 
for varied lengths of incubation by analyzing and studing occa- 
sional exposure to infection, and continuous and frequent exposure. 
Length of incubation is very deceptive in leprosy, owing to the 
complex and multiplicity of causes that may hasten or retard the 
progress of the disease. 

Sooner or later the incipient leper gradually accumulates suffi- 
cient toxin in his system, the leprosy shows itself, and he himself is 
in a condition to infect other susceptible persons, and becomes an 
independent distributing focus of fresh infection. 

LEPROSY IS NOT PATHOGENIC TO ANIMALS 

Fortunately for the human race, leprosy is not a disease pre- 
vailing in the animal kingdom. If this disease had other allies 
external to man, it would be in a position to scourge mankind in a 
manner similar to tuberculosis. 



If the sputum of the leper possessed the same infective property 
as that of the tuberculosis victim, also if leprosy existed in the ani- 
mal kingdom, and hence aided the spread of that disease, it would 
not be an extreme inference to draw, that annihilation of the Ha- 
waiian race would have come about ere this. 

In Hawaii it would cause the most indifferent of us to shudder, 
to realize that our cows, horses, dogs, cats, chickens, pigs and our 
fish could become affected with leprosy. Such a state of affairs 
would be a most appalling calamity. 

# * * 

Providence has decreed that man alone shall be the host for the 
bacillus leprae, whilst tuberculosis is inflicted on both man and 
animals. 

In and around the hospital enclosure at Kalawao, the various 
domestic animals acted as scavengers, consuming the debris and 
leavings of the kitchen and dining room and of the hospital wards. 

The contents of the bedpans and chambers, owing to the ab- 
sence of suitable toilets, were emptied around at some distance from 
the hospital buildings, resulting in a rank growth of grass which cat- 
tle and sheep fed on with impunity, the pigs and chickens eat the 
faeces, kitchen swill and refuse was consumed by the dogs and 
hogs. Left-off dressings and poultices of sweet potato, linseed, and 
bread, were also an addition to the diet of the scavenger animals 
and the cows. 



THE PATH OF THE DESTROYER 169 

No animal showed any ill effects from their morbid meals; on 
the contrary, they kept in prime condition. 

Some of the dogs and pigs presented a mangy, hairless and 
scabby appearance with many cutaneous ulcers, but no true leprosy. 

The so-called rat leprosy was never in evidence at Molokai. 

The non-pathogenic infective property of leprosy to animals 
cuts off a formidable source of leprous infection to man; hence, 
when the last leper becomes defunct, leprosy will disappear off our 
earth, because there will be no other suitable host remaining to 
nourish and keep alive the parasite, the bacillus leprae. 



A significant axiom. — Any person, be he doctor, priest, nurse, 
attendant, or other, who ABSTAINS from taking ordinary care 
to protect himself from any known or suspected contagious disease, 
has no one but himself to blame if he falls a victim to a disease 
with which he is hourly, daily, weekly, and monthly in contact. 

Postulate. — Any man who assumes without absolute irrefutable 
proof that leprosy is non-contagious is taking a dangerous position ; 
and yet there are hundreds who do. Read the report on leprosy 
of the Royal College of Physicians, London, in the year 1867, who 
decided that leprosy was a non-communicable disease. I hold a 
diploma from that august body, yet I must differ from the findings 
set forth that leprosy is a non-contagious malady. 

The communicability of leprosy again came prominently to the 
fore about the year 1890, chiefly owing to the world-wide adver- 
tising Hawaii obtained through the case of Fr. Damien. 

Leprosy was claimed to be an imperial danger and a menace to 
the British Empire ; an investigation was ordered. The Prince of 
Wales' commissioners visited India and made an exhaustive investi- 
gation, deciding that leprosy was not an imperial danger — that it 
spread "by ways and means unknown," also the general trend of 
the evidence obtained by this commission led them to conclude that 
leprosy was non-contagious and need not be segregated, a conclu- 
sion arrived at from the status of the disease in India. 

Primary mouth infection diseases, like cholera and typhoid, 
from whence they enter the alimentary canal, will never infect a 
CAREFUL CONTACT, and I apply this same statement mark- 
edly to those who have intimate contact with the leper; but, un- 
fortunately, this very condition of non-infection by leprosy of a 
careful contact, is used as an argument that the disease is non- 
contagious. 

Now this pernicious assumption has lured hundreds of un- 



170 THE PATH OF THE DESTROYER 

fortunate people to their doom, and the disease continues its activity, 
and keeps spreading and spreading. 

Previous to the year 1883, the question of nursing for the 
lepers had received no attention; it being quite impossible to obtain 
trained and faithful nurses in Hawaii, owing to the loathsome and 
repulsive nature of leprosy. Mr. W. M. Gibson, president of the 
Board of Health, in January of the above year, appealed to Bishop 
Herman, Bishop of Olba, head of the Catholic mission in Hawaii, 
to obtain Sisters of Charity from one of the many sisterhoods in 
the United States to come to Hawaii and help in the care of the 
leper women and girls. 

Bishop Herman designated Father Leonore as agent to go 
on this mission, King Kalakaua giving him also a royal com- 
mission. After petitioning over fifty different religious sisterhoods, 
a favorable reply was given by the Franciscan Convent of Saint 
Anthony, at Syracuse, New York State. 

Before acceding to the appeal for nurses for the lepers, the 
question was long and seriously debated in a solemn chapter of the 
Sisterhood, and finally twenty-four Sisters nobly volunteered their 
services. Of this number six were chosen, and accompanied by a 
Mother Superior, Sister Marianne, arrived at Honolulu November 
8, 1883. Whilst there have been some changes through death 
and transfers, Mother Marianne is still alive, and others of the 
original band still survive. 

Five years were spent nursing and taking care of the sick 
lepers in the Kakaako hospital near Honolulu. 

November 14, 1888, the Mother Superior and other Sisters 
transferred to Kalaupapa, and are now at the Bishop Home for 
women and girls. 

For over THIRTY-TWO years these Sisters have been con- 
tinuously in contact with leprosy in its most severe, loathsome, and 
repulsive conditions, and lo ! NONE of them have become affected 
with the disease; hence the conclusion is drawn by many people 
that, leprosy is non-contagious, whereas, the real solution and an- 
swer to the cause of the Sisters' immunity is their cleanliness and 
careful contact. 

Washing and cleansing ulcers, wounds, and other duties of 
a nurse, are fearlessly and conscientiously performed hour after 
hour. When their duties are over, personal cleanliness is never 
forgotten, and contaminated hands are carefully cleaned. 

Did you ever hear of a Sister eating with her leper charges? 
The answer is NEVER, and you never will. 











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172 THE PATH OF THE DESTROY ER 

All food and drink partaken of by members of the sisterhood 
is scrupulously clean, and not contaminated by leper contact or 
hands. All their cooking and laundry work is performed by non- 
leper servants. 

Careful contact is the explanation of the cause of the freedom 
of the Sisters from leprosy, not the non-contagious character of the 
disease, and this statement applies to many other diseases besides 
leprosy. 

Immunity may be falsely assumed as the cause of non-infection 
with a contagious disease, whereas the true explanation may be 
discovered in the extreme carefulness of contact or contactee with 
the disease. 

Where there is so much difference of opinion on the contagious- 
ness of leprosy, it is better to err on the safe side and accept the 
dicta of wisdom and experience, which indicates contagion — at least 
in Hawaii — and where also non-contagion is the ally of ignorance 
and inexperience. Because a prolonged and intimate contact with 
leprosy fails to infect in all cases, it is no good ground for con- 
cluding the disease is non-contagious. 

The frequently made statement that So and So lived amongst 
leprosy for years and never contracted the disease, is simply a 
confession of ignorance of the lurking danger, and is equivalent to 
stating that many soldiers go into battle and never receive a wound, 
therefore there is no danger — this is only a partial truth. 

There are numbers of houses in various parts of the islands 
where case after case of leprosy has developed amongst the in- 
mates, father, mother, or children and grandchildren becoming lep- 
ers; these conditions all indicate that leprosy in clinging to a 
dwelling is truly A HOUSE DISEASE, and its presence can lie 
explained on other grounds than heredity. In these houses frequent 
and continuous facilities by divers intimacies to acquire leprosy are 
ever present, and this is the daily routine. The disease is propa- 
gated or spread because it is contagious, not because of its hereditary 
tendency, and the intimate family association with the leper night 
and day is the foundation of the contagion in these leper houses. 

A soldier on outpost duty is greatly exposed to danger; he 
knows his peril and is ever ready and alert. 

A doctor, priest, nursing Brother or Sister at the Leper Settle- 
ment should know they are in the front rank of the danger line, 
and should be constantly on the alert and careful, and maintain a 
high standard of cleanliness, eating food_ not exposed to leprous 
contamination, admit no lepers to their rooms, have no leper cooks 



THE PATH OF THE DESTROYER 173 

or laundry work performed by lepers, and also maintain the highest 
standard of cleanliness of hands, teeth, clothes, and the whole 
person. 

I assert anyone in contact with leprosy in its worst form (and 
living up to the standard of cleanliness I have outlined) need not 
have any fear of becoming infected with the disease, but let slovenly 
and uncleanly habits be the rule, then the risk is very much in- 
creased and no surprise need be expressed if the person pursuing 
uncleanly methods of living becomes a leper. 

I claim there is very little risk of leprous infection at the 
Settlement to careful persons ; the danger is ever present and 
known ; outside the confines of the Settlement leprous infection is 
just as likely to occur, hidden foci of leprosy lurking outside where 
they are unexpected, like the highwayman hiding around the coroner. 

I have knowledge of ONE Catholic priest who had leprosy, 
yet he never visited the Leper Settlement. I also know of two 
physicians who had leprosy, and neither of them had ever set foot 

on Molokai. 

* * * 

In a previous chapter, I have drawn special notice to the sub- 
lingual reservoir being the habitat of the bacillus leprae, the pocket 
formed by the inner surface of the cheeks and the inferior maxilla, 
is also a frequent situation where the bacillus leprae can be found, 
and I venture to assert that no external or visible signs of leprosy 
may be in evidence on the face, yet the bacillus may be lurking in 
the mouth, and in addition to what I have written in a previous 
chapter, it is quite within the bounds of possibility that many people 
may eat with and kiss a carrier of leprosy of this character without 
being aware of it. In this connection, I call to mind the solemn and 
pathetic declaration of two white women who became lepers: "Before 
God in Heaven we never saw a leper until we were taken to Kalihi ; 
we cannot believe we have leprosy, we never slept in native houses." 
One of these women had never touched, and avoided, if possible, 
shaking hands with any Hawaiian; never had eaten poi, or had 
any close contact. The other woman was not so discreet, admitted 
having eaten poi, but had carefully cleansed her hands with soap 
and water before and after eating, admitted kissing Hawaiian girls 
and other female members of the household where she was a guest. 
Both these women had nodular leprosy and were addicted to using 
alcohol in excess. 

There is this comfort for mankind. The bacillus leprae is a 
very feebly contagious parasite, a statement which any reflective and 
thinking layman in Hawaii can corroborate. Its contagion is far 



174 THE PATH OF THE DESTROY ER 

from virulent, judging from the remarkably small number of for- 
eigners affected with leprosy in Hawaii in the past fifty years. 

When Fr. Damien fell a victim to leprosy and later suc- 
cumbed to the disease, his semi-tragic death created a marked change 
and revulsion in the opinions previously held about the non-con- 
tagiousness of leprosy. A certain element of the British public be- 
came alarmed when they learnt of the case of Fr. Damien; rushed 
into print, and almost hysterically proclaimed leprosy to be an 
imperial danger and menace. 

The London College of Physicians, who were the chief ex- 
ponents and advocates of the non-contagiousness of leprosy, as stated 
in the declaration of their conclusions in the year 1867, began to 
hedge, and materially modified their opinion in the year 1887. 
Later on, in the year 1889, soon after Damien's death, the said 
college recanted, veered around, and admitted the contagiousness of 
leprosy. 

Even Norway, a stronghold of non-contagion views, due to 
the teachings of Boeck, Danielssen, and Hansen (of bacillus leprae 
fame), began to switch, became converts to the views of the con- 
tagionists, and warmly advocated and supported them. 

What caused this revulsion in the opinions of these famed 
Norwegian leprologists, Danielssen and Hansen? (Boeck having 
died in the year 1875.) 

1. They had seen the beneficial check to the spread of leprosy 
in Norway by only partial segregation, even this had caused a 
marked diminution in the disease. 

2. The rapid and continuous spread of leprosy in Hawaii. 

3. The infection of Fr. Damien with leprosy. 

If no other effect has been produced by the history of the life 
and death of Fr. Damien, it at least has wakened the medical 
profession from their lethargic state, and made them regard leprosy 
as a lurking danger to those in contact with it. 

The general clinical view that we have of leprosy ought to 
convince us that it stands alone in a class by itself — its presumed 
length of incubation is remarkable, but some other pathogenic bac- 
teria act the same. 

Individual predisposition may or may not determine the con- 
tagiousness of leprosy, even in the face of the stereotyped general 
and vague remark that, "Whatever lowers the standard of health, 
must necessarily be a factor in inviting leprous infection." I cannot 
accept this statement in the face of the numbers of Hawaiian lepers 
I have known, who possessed a splendid physique, whereas puny 



THE PATH OF THE DESTROY ER 175 

and ill-developed Hawaiians failed to contract the disease under 
similar conditions of exposure. 

Apparently cured or aborted cases of leprosy may, and do, 
break into activity on fresh contact with the disease. There are 
good and valid reasons to believe that fresh seats of infection have 
been brought into activity. 

In three cases of leprosy where the disease had remained qui- 
escent for four, seven, and nine years respectively, and there was 
no contact during these periods of time with lepers, subsequent 
exposure and daily contact with nodular leprosy caused the disease 
to become active in the four-year case aften ten months of contact; 
in the seven-year case after twenty-two months of contact; and in 
the nine-year case after seventeen months of contact, and in all, the 
disease remained permanently active and never again became qui- 
escent, and finally killed these victims of secondary infection, or re- 
infection. 

THE PROVED FACT THAT PROLONGED AND IN- 
TIMATE CONTACT WITH LEPERS SELDOM INFECTS 
PRIESTS, DOCTORS, NURSES OR OTHER CLOSE CON- 
TACTS, IS STRONG EVIDENCE IN FAVOR OF THE 
LIMITED CONTAGIOUSNESS OF LEPROSY, IT ALSO 
POINTS TO THE ALIMENTARY CANAL AS THE RE- 
CIPIENT OF THE BACILLUS LEPRAE; IF SYSTEMIC 
INFECTION TOOK PLACE BY THE BREATH, SPUTUM, 
NASAL DISCHARGE, INFECTED DUST AND OTHER 
LIKE AGENTS, THEN IT IS PLAIN THAT ALL THE 
ABOVE CONTACTS MUST ASSUREDLY SHOW A 
GREATER RATIO OF INFECTION. 

The leper may reach the usual span of life, but such cases 
are few and far between in Hawaii, and are mainly comprised of 
the neural type. Mr. Ambrose Hutchison, whose history will be 
found in this book, has had the disease over forty-seven years. 

Now comes the important point. During the long periods of 
latency and quiescence what is the bacillus leprae doing? I claim 
it is dormant, and its capability of transfer and infection is very 
remote; the leper in this state is a carrier of leprosy of doubtful 
danger. 




OUR RACIAL AMALGAM. 

Japanese-Chinese-Hawaiian. 
Father is Japanese-Hawaiian. Mother is Chinese-Hawaiian. 



THE PATH OF THE DESTROYER 177 

During these periods of inactivity some cases of the neural 
type of leprosy show no bacillus in the nasal and buccal secre- 
tions, a small minority do. 

When as rarely happens, the nodular and mixed forms of 
leprosy take on lengthy periods of quiescence, the mucous membrane 
of the mouth will generally show continued activity of the disease 
in the form of tongue ulcers and erosions of the buccal mucosae, in 
the scrapings from these lesions, bacilli can be demonstrated. 

Nasal discharge with ulceration of the septum nasi, may or 
may not have an important bearing on the question of contagion; 
many abortive or quiescent cases of leprosy continue to have nasal 
discharge, as practically the only active symptom of the presence of 
leprosy all their lives. The disease makes no progress, although 
bacilli are present in the nasal discharge; until further research 
demonstrates the contrary, I claim the bacilli are dead (cadaveric) 
and harmless. In one such case, this alleged active symptom of 
leprosy has continued for over thirty years, without any change 
in the general health and tissues of the body of the person so af- 
fected — a foreigner. These nasal aqueous discharge and mucous 
mostly contains bacilli, mutilated and of defective formation, and 
it is reasonable to assume that the blending of the acrid watery dis- 
charge and air contact, are the factors which render these bacilli 
cadaveric and harmless. 

From the very nature of the source I regard the bacillus 
leprae in the mouth as formidable and to be dreaded ; this I have 
discussed in previous pages. There are also strong reasons to 
assume that like its ally, the bacillus tuberculosis, the bacillus leprae 
is FACULTATIVE ANAEROBIC, it can exist and reproduce 
itself at a better advantage where there is NO oxygen. 

Closing this chapter on contagion, I may reiterate. — Conjugal 
contact with syphilis generally infects the healthy consort; with 
tuberculosis infection does occur, but most of the healthy consorts 
escape. With leprosy, owing to its slow progress, there is more 
prolonged exposure to infection than in the average run of tuber- 
culosis cases ; yet in leprosy most of the healthy consorts also escape 
infection. 

To conclude the subject. — There is an ominous preponderance 
of evidence in Hawaii, all of which tends to prove and affirm the. 
contagiousness of leprosy. 



178 THE PATH OF THE DESTROYER 

HEREDITY 

Post natal infection. — Most, if not all the cases of leprosy 
occuring in the children of leper parent or parents can be so 
explained. 

Significant facts, tending to prove that leprosy is not heredi- 
tary through the leper mother, are the following: Absence of the 
bacillus leprae in the FOETUS, PLACENTA, and LOCHIA 



CHAPTER VI. 



LEPROSY MORE PREVALENT IN THE MALE SEX 

Leprosy prevails more frequently amongst the male sex, the 
ratio of infection compared with the female is about 2 to \]/\. 
Almost all the countries of the world show a preponderance of 
male lepers. 

That it is not due to the large excess of males in the popu- 
lation is evident from the following figures taken from the last 
census, year 1910: 



Race 


Male 


Female 


Excess Male 


Excess Female 


Hawaiian 


13,439 
4,438 
1,812 


12,602 
4,334 

1,922 


837 
104 




Caucasian-Hawaiian 
Asiatic-Hawaiian 


110 


Total .. 


19,689 


18,858 


941 









Total Females 18,858 



Excess of Males. 



831 



The text-books on medicine inform us that males are more sub- 
ject to nephritis, pneumonia, etc., because they are more exposed to 
the weather than females. When I was an immature medical stu- 
dent, I used to ponder over this statement and wonder how it 
could be proved, and concluded that exposure was a very remote 
cause indeed, unless the kidneys and lungs were damaged previously 
from some other more obvious cause. 

Whilst the exact reason of the more frequent prevalence of 
leprosy amongst the male sex cannot in our present knowledge of 
that disease be determined to clearly meet all objections, neverthe- 
less I will endeavor to show that the male is more exposed to con- 
tact with the disease than the female, and this phase or state of 
more exposure to infection may account in a certain measure for 
the greater prevalence of the disease in the male. 

Many conditions prevail in Hawaii bearing on THE CAUSE 
OF EXCESS MALE LEPROSY that do not exist in other en- 
demic leper countries. I do not feel competent to discuss this 
matter as it exists external to Hawaii, my statements alone apply 
to this latter country. 

The Hawaiians are gregarious in their habits, and travel from 
place to place; any steady occupation is unsuitable to their tempera- 



180 THE PATH Of THE DESTROY ER 

merit, they are pleasure loving, and any sustained effort of mind 
or body palls on them. 

I speak of twenty years ago. The Hawaiian pursuing his 
daily labor away from his home never carried any dinner pail, but 
ate and slept in the house of some friend near to his work. 

If the Hawaiian was a fisherman, just as often as not, after 
being several hours in the sea, he was perhaps miles from his home. 
He landed and slept at the nearest house. 

If he went up into the mountains and became belated or be- 
nighted he sought a nearby house. 

The cowboy miles away from his home at meal times, sought 
the nearest house for food and shelter. 

Hospitality with the Hawaiians is or was a remarkable vir- 
tue; no stranger was ever refused food or shelter. 

The female Hawaiian, while not a stay-at-home person, did 
no such traveling about from house to house, eating here and there. 
In former years, horses were cheap and numerous, the unfenced 
lands bordering the roads gave free pasture to horses whenever 
their riders rested. There was more traveling two decades ago 
than today, and greater facilities existed for frequent contact with 
unsegregated lepers. 

The female Hawaiian generally remained at home except per- 
haps on Sundays, or bi-weekly visits perhaps were paid to the 
nearest store, sure to have a Chinese proprietor. If the woman 
wished for food, poi was rarely to be had, but bread, tea, cake, 
and pie ; furthermore, the woman was not likely to have a leper 
companion during her meal — the Chinese avoid the leper. The 
food supplied was fresh and cooked, not promiscuously handled by 
any chance leper. 

The male Hawaiian, on the other hand, in his travels may be 
said to have had invariably poi and fish for his meal, all his fellow- 
eaters using the same dish, and if there was a leper amongst them, 
the visiting Hawaiian would not avoid his company, but eat and 
drink and sleep with him just as likely as not. 

The report of W. N. Armstrong, president of the Board of 
Health, to the Legislature, year 1882, states as follows: 

"There are probably 2,000 lepers in the Kingdom or 5% 
of the whole native race. It is probable that as many more have 
the seeds of the disease.'' 

Leading the life the native Hawaiian led at that time, rest- 
less, moving frequently from village to village, sleeping and eating 
when and where he saw fit, the probability of promiscuous con- 
tact with lepers would be a certainty, and the traveling Hawaiian 




HAWAIIAN JAPANESE. 



182 THE PATH OF THE DESTROYER 

would take no steps to avoid contact with them; on the contrary, 
he would court their society, smoke their pipe, eat out of the same 
dish, sleep on the same mat and so forth. 

The contact of the traveling Hawaiian with leprosy was not 
once, twice, or occasionally, it was continuous; the traveler would 
rest a week or two, then begin again, hence the prospect of infec- 
tion was practically ever present. 

Mr. W. N. Armstrong's statement about the number of lepers 
and possible lepers reaching a total of 5% of the population is not 
far from the truth, the subsequent years of segregation go to prove 
its correctness. "In said year 1882, 706 lepers were in segregation 
at Kalawao." Further on in his report Mr. Armstrong states, 
"there are 400 lepers in Kakaako and Honolulu City." 

The hospital at Kakaako was a sham, segregation was in name, 
not fact, the leper and non-leper could kiss each other, smoke the 
same pipe, pass in food through the leper-proof fence (?). Now 
I except Honolulu on this more frequent exposure of the male to 
leper contact, in this city the sexes would have equal exposure and 
opportunity of contracting leprosy. 

In the districts of the islands not closely adjacent to the larger 
villages and towns, poi is manufactured and kept for sale in some 
house or small store. 

The taro patches contiguous to the homes of the Hawaiians 
were leased to some head man or Chinese, who manufactured the 
taro into poi, and from whom this article was purchased. To my 
own knowledge in ten instances, a leper worker was employed in 
these poi factories, one Chinese poi maker was a leper, two Cau- 
casian-Hawaiians were lepers, and the remaining seven leper poi 
makers were of the Hawaiian race. 

The residents residing near the poi shop sent a member of 
the family to obtain the family poi, and from close observation I 
observed it was generally a member of the male sex, very occasion- 
ally a grown girl, or young woman. If poi had to be obtained 
at some distance from the home, a mile or more, some male mem- 
ber of the family (grown up) was sent for it. 

It is just by such evidence as this, furnished link by link, that 
a chain of more exposure of the male can be built up and the pre- 
ponderance of the disease in that sex explained in part. 

Again, let us suppose a young girl or a young woman has the 
leprosy, the disease makes no difference to the Hawaiian lover; he 
will visit and eat with her, and she may possibly infect him. The 
girl may tire of her lover, and another comes on the scene, she 
infects him, and the process goes on indefinitely. 



THE PATH OF THE DESTROY ER 1S3 

I have a history of four cases where young women, Hawaiians, 
had leprosy, and where, owing to the arrival of a stepmother, the 
brothers and half-brothers were driven from the house; later on 
in the absence of the stepmother, clandestine visits were paid to 
these young women by their brothers and lovers. Of course they 
ate with them, the usual diet of poi and fish, and to be polite, the 
women in the case stirred up and freshened the poi (with un- 
washed hands), the usual proceeding. 

The result later — four brothers of these girls or young women 
acquired leprosy, and two of the lovers. 

It is not the penile inoculation that spreads the disease, it is 
the leprous contaminated food — poi, fish, or whatever else may have 
been handled by the leper, or that has direct contact with his mouth. 

In promiscuous Hawaiian hospitality lurks hidden danger. 

The preceeding remarks are an attempt to show that the male 
is more exposed to leper contact than the female, and may acccfont 
in part for more male than female lepers. 

I reiterate, the contagium of leprosy is so mild that it deceives 
many competent observers, and leads them to conclude that the 
disease cannot be spread by contact. They judge the infective prop- 
erties of the leprous discharges by the high standard of tuberculosis 
infection. 

In order to explain the low degree of contagium of the secre- 
tions and dischages from the leper, we must conclude that free 
contact with the air renders the bacilli inert, causes them to lose 
infective properties, and become cadaveric, all of which statements 
I have made under other headings. 

In former years I held to the idea that menstruation was a 
factor to be reckoned with in lessening the receptive status of the 
female to leprosy, but I have retreated from that belief with my 
wider and longer experience with the disease. 

At the present day my views are, in the light of more mature 
investigation, that the menstruating female and the non-menstruating 
are equally liable to leprosy. 

I have known forty females, all over twenty-five years of age, 
who had never shed a drop of blood from the uterus, and not one 
was a leper, although ten of them had leper relatives. 

Two conditions, in the role of the progress of leprosy in Ha- 
waii, appear to have changed during the past twenty-five years: 

A. The greater susceptibility of the male seems to be de- 
creasing. 

B. The period within which most cases of leprosy develop in 
the female is now between the ages of eighteen to thirty years. 



184 THE PATH OF THE DESTROYER 

NUMBER OF SEGREGATED LEPERS AT MOLOKAI 
JUNE 30, 1915. 

Males 382 

Females 256 

Total 638 

Males approximately 60%, females 40%. 
Over 81% of the lepers are Hawaiians and part-Hawaiians. 

Hawaiians 522 

Caucasians 61 

Asiatics 55 

Total 638 

NATIONALITY 

Hawaiians 416 

Caucasian-Hawaiian ) -j^/- 
Asiatic-Hawaiian ) 

Chinese 32 

Japanese 13 

Korean 10 

American 3 

Belgian 1 

German 6 

Porto Rican 2 

Portuguese 46 • 

Russian 1 

Spanish 2 

Total 638 

ANNUAL TOTAL OF SEGREGATED LEPERS AT 
MOLOKAI, AS OF JUNE 30th. 

YEAR NUMBER DECREASE INCREASE 

1910 614 

1911 595 19 

1912 622 .... 27 

1913 683 .... 61 

1914 666 17 

1915 638 28 

64 88 

INCREASE 24 




ASIATIC-HAWAIIAN TYPE. 

Chinese Father — Hawaiian Mother. 



186 THE PATH OF THE DESTROYER 

MISCELLANEOUS TOPICS PERTINENT TO LEPROSY 

There is this significant evidence to indicate that the alimen- 
tary canal is the main location of the general systematic infection 
and entero-toxism that exists in the leper. 

"THE SOLE REMEDIES THAT HAVE ANY BENE- 
FICIAL EFFECT IN LEPROSY ARE GASTROINTESTI- 
NAL STIMULANTS AND DISINFECTANTS, WHOSE 
ACTIVE PRINCIPLE IS A TERPENE, ISOMERIC WITH 
OIL OF TURPENTINE." 

The active principle of cashew, eucalyptus and gynocardia is a 
volatile oil somewhat complex in composition, a mixture of isomeric 
hydro-carbons (terpenes), all have the formula Go H™. All the 
above remedies will certainly retard the progress of leprosy, but 
there is no cure in sight. 

Carbolic acid, iodoform, creosote, bismuth salicylate, naphthol, 
salol, thymol, sodium sulpho-carbolate, and sodium salicylate are 
gastro-intestinal antiseptics and disinfectants, but they all lack the 
stimulating principles of the volatile oils. Amongst these drugs 
sodium salicylate is the only one of any value, also magnesium 
salicylate, which should be pure (contain 85% of natural salicylic 
acid, not the artificial, and 15% of magnesium). 

Pathogenic bacteria thrive best in alkaline media, hence the 
lactic acid producing Bulgarian bacillus is a valuable remedy in 
leprosy. 

Attendants on lepers, who are exposed to continuous intimate 
contact should take salicylate of soda in one-gram doses twice 
daily, two days a week at intervals of three days. The salicylate 
is excreted in the saliva, and its presence can be detected for several 
days after taking; it has a powerful germicidal action against any 
bacilli which may inhabit the mouth; also, one day of each week, 
four grams of magnesium salicylate should be taken two hours 
after each meal. 

PRIMARY AND SECONDARY PHYSIOLOGICAL 
EFFECTS OF THE VOLATILE OILS 

Externally. — Stimulation of the skin, redness, tingling, even 
vesication. 

Internally. — Stimulation of the gastro-intestinal tract, hence 
increase of vascularity, saliva, gastric juice, and fluids of the in- 
testine, and excitation of the unstriped muscular fibres. 

In average doses the volatile oils are stomachic and carmini- 



THE PATH OF THE DESTROYER 187 

tive, in large doses they assume irritant properties. The stimu- 
lation of the stomach accelerates the heart and central nervous 
ganglia, skin secretion and mucous membrane of the bronchi. Ex- 
creted by the kidneys, they irritate and stimulate (hence are diur- 
etics), and the genito-urinary tract is also acted on in like manner. 

Eucalyptus oil is powerfully antiseptic and disinfectant. In 
medicinal doses it stimulates the heart reflexly through its action on 
the stomach ; it imparts its odor to the breath, disinfects the urine 
and faeces, acts on the skin as a diaphoretic, on the bronchi as an 
expectorant, on the kidneys as a diuretic, and stimulates the mu- 
cous membrance of the bladder. Much increase in the dose, over 
five minims, irritates the stomach, causing vomiting, diarrhoea and 
pain, slows the heart and lowers the temperature, depresses the 
nervous centers and may cause hematuria. 

The therapeutic action of eucalyptus and gynocardia or chaul- 
moogra oils are almost identical, the latter causes more stomach 
irritation, and hence is more nauseating. 

It is possible to explain the reasons why the use of gastro- 
intestinal stimulants and disinfectants fail to effect a more effective 
and permanent benefit in leprosy, based on the theory that intes- 
tinal antiseptics destroy or diminish the benign and protective bac- 
teria which exist in the intestinal tract under normal conditions, 
while the volatile oils are destructive to the bacillus leprae and its 
toxins, they also destroy and eliminate the various bacteria, which 
are helpful and assist the normal intestinal functions. 

POSSIBLE EXPLANATION OF THE THREE FORMS OF 
LEPROSY— NODULAR, MIXED, NEURAL 

When several members of a family are affected with leprosy, 
the same type is present in all — nodular in all, or neural in all. 
Why the nodular type should specially select the skin and mucous 
membranes, and the neural type have predilection for the nerves 
and sheaths cannot be definitely determined from our present knowl- 
edge of the disease. 

Undoubtedly the primary form of leprosy is nodular, then 
comes the intermediate, the mixed form, possessing features com- 
mon to the nodular and neural forms, and lastly comes the neural 
form. 

Possibly each receptive individual has some peculiar condi- 
tion of the system that determines his type of leprosy, hence the 
members of his family will all have the same type following that 
of the parent. 



188 THE PATH OF THE DESTROYER 

It is conceivable that the bacillus leprae in its initial entry into 
the system has a FIXED INSTINCT OF LOCATION defi- 
nitely determined, which leads to the bacilli seeking the skin and 
mucous membranes and locating there, causing the phenomena and 
appearance of the disease which we name nodular or tubercular 
leprosy. 

This form of the disease is the usual and most prevalent type, 
and the cause of the change, modification, or deviation therefrom 
must be sought for in some idiosyncrasy of the body tissues and 
secretions. It is reasonable to assume nodular leprosy can be 
changed to neural leprosy under this theory, and also this meta- 
morphosis must take place in the early stages of the bacillary life 
in the human system. 

It is reasonable to assume (which alone is possible in our 
present limited knowledge of the true condition), that some mem- 
ber of the pathogenic bacteria of the intestinal tract may be re- 
sponsible for this change of INSTINCT OF LOCATION, 
which determines and decides the selection of the bacillus leprae 
for the nerves and nerve sheaths. 

The change must be made before the bacillus seeks its home by 
means of haemal and lymphatic circulation, and the bacillus aero- 
genes capsulatus, present in excess in cases of marked intestinal 
putrefaction, may be a possible factor; polyneuritis and muscular 
atrophy are commonly associated with the presence of this bacillus. 

If this bacillus can have an augmenting influence in cases of 
intestinal derangement, and aid morbid lesions in the nerves, both 
central and peripheral, it is reasonable to conceive that the bacillus 
leprae arriving on the scene may have its instinct of location 
moulded and changed by the paramount influence of the B. aero- 
genes capsulatus, and the bacillus leprae, instead of locating in the 
skin and mucous membranes, locates in nerve and nerve tissues. 

ALCOHOL IN LEPROSY 

The injurious effects of excessive use of alcohol upon the 
system are only too well known to the pathologist, and even to 
the educated .layman. 

An agent that causes grave changes in the structure of the 
arteries and nerves cannot be looked at askance with leprosy 
lurking around. 

The identical morbid changes that leprosy, by the aid of its 
bacillus, produces, to wit. : peripheral neuritis, arteritis with arterio- 
capillary fibrosis, etc., is also produced by the abuse of alcohol in 
its verious forms and grades; quite apart from its irritant and 



THE PATH OF THE DESTROYER 189 

poisonous effects on the other portions of the human system, alco- 
hol cannot be looked on in any other light than a faithful ally of 
leprosy. 

From an experience of over three decades, I can assert with- 
out fear of contradiction that the deluded creatures who are in the 
clutches of alcohol, drinking to excess when in contact with lep- 
rosy, are much more liable to contract the disease than those who 
use alcohol moderately or do not use it at all. This statement is 
also applicable to tuberculosis. 

Every word that the late Dr. Brinckerhofr" used in his able 
and classical thesis on the connection of ALCOHOL and LEP- 
ROSY I endorse, and also his clear and incisive conclusions on the 
subject matter of his thesis. 

The abuse of alcohol in Hawaii by a certain race cannot < be 
viewed by any thoughtful person, save with mingled feelings of 
sorrow and dismay. 

The rapid decimation of this race is markedly due to the ex- 
cessive use of alcohol. It not only destroys the present members 
of the race, but also the coming ones. Healthy and sturdy chil- 
dren cannot be begotten by drunken parents. 

The ravages in the system of man induced by the ABUSE 
of alcohol are due to : 

1. Its direct irritant action. 

2. Its deleterious influence on the vaso-motor nerves, which 
control the expansion and contraction of the walls of the blood 
vessels. 

3. Organic visceral lesions and degenerative changes. In the 
stomach, congestion, chronic catarrah, fibroid and glandular de- 
generation. Atrophy of various organs, tissues, and nerve centers. 
In advanced "tipplers," grave nervous lesions as absolute dementia, 
peripheral neuritis, extreme muscular trembling and weakness, 
paralysis or ataxia, epileptiform attacks, finally coma. 

4. The decomposition and entrance into the circulation of 
the poisonous elements of the alcohol. 

5. Interference with tissue — metamorphosis, oxygenation and 
nutrition. 

It seems unnecessary to state that the stronger alcohols, rum, 
whiskey, brandy, and gin, taken repeatedly and undiluted on an 
empty stomach, are among the most insidious habit-forming and 
destroying agencies of the human race on our planet; also their 
presence and continued abuse is one of the greatest blots, menaces, 
degradations, and disgraces of our much vaunted civilization of 
the twentieth century. 



190 THE PATH OF THE DESTROYER 

As long as our so-called paternal government degrades itself 
and stoops to license the drink trade, just so long will its victims 
and dupes swell the ranks of maniacs, degenerates, consumptives, 
and lepers. 

In alcoholic peripheral neuritis trophic changes occur in the 
nails, skin, muscles, due to defective nerve function ; the symptoms 
are milder than in the infective neuritis of neural leprosy. 

Peripheral alcoholic neuritis is certainly a first cousin to leprous 
neuritis. 

I am strongly of opinion that the disease called syringomyelia 
(abnormal cavities or spaces in the substance of the spinal cord), 
as described by Drs. Jean Martin Charcot of Paris, and Moritz 
Schiff of Germany, is neural leprosy, modified by the effects of 
alcohol, and this disease may be transmitted from parent to off- 
spring. 

The peculiar disease met with in Brittany described by Dr. 
Morvan, and bearing his name, carries all the earmarks of nerve 
leprosy complicated with alcoholic neuritis. 

Briefly stated, the history of alcohol and disease in Hawaii is 
as follows: 

From July 1, 1908, to June 30, 1914, a six-year period, 
amongst the Hawaiian race 5,835 deaths were registered, an aver- 
age annual mortality of 972 and a fraction over, about 27 per 
mille or thousand. The death rate of continental U. S. is some 
18 per mille; about 10% of the deaths are caused directly and 
indirectly by alcohol. 

The Hawaiian death rate is 33% more per mille — computing 
on a 14% basis gives 136 deaths due to alcohol, out of the annual 
death rate of 972. 

These 136 deaths represent an annual toll levied directly by 
alcohol on our weaker brothers and sisters, who cannot resist the 
temptation, drink to excess, and are sacrificed on the altar of the 
alcohol god. 

ARTIFICIAL LEPROSY 

I have failed to inoculate by skin abrasion, rabbits, cats, rats, 
guinea-pigs, and in one instance a mongoose (a fierce and untamable 
animal), this also being the experience of many other workers in 
the same field. I will brieflly describe the method and results 
obtained. 

Whenever I had a supply of leper blister serum, I inoculated 
the above animals in pairs, except the mongoose, one experience 
with this animal was enough. I chose the inside of the ear for 



THE PATH OF THE DESTROY ER 191 

the seat of inoculation, because the animal cannot, lick the wound, 
using antiseptic measures, scarifying a surface about the size of a 
ten-cent piece, rubbing in the blister serum similar to the operation 
of vaccination. 

All these experiments failed to produce any leprous infection. 

I continued the experiments for several months with no suc- 
cess, then, chiefly due to lack of assistance and proper care of 
the animals, some died, others escaped from the pen. I had 
remaining one rabbit, two guinea-pigs and one cat, and in the tenth 
month from the date of their first inoculation, I killed them, the 
resulting examination by the naked eye and the microscope, gave 
no signs of leprous infection. 

In the summer of the year 1885, I examined a monkey Dr. 
Arning had inoculated (with blood serum and the juice from a 
leproma), some ten months after inoculation had taken place; 
at that time nor subsequently did any systemic leprous infection 
occur. The next year the doctor left Hawaii and returned to 
Germany, but I learnt afterwards that the monkey had died never 
showing any signs of leprosy. 

Some twelve years elapsed, and, being firmly convinced of the 
improbability of reaching any results from dermal inoculation, I 
decided to try to obtain leprous infection through the mouth and 
alimentary canal and peritoneum. 

I was able to obtain a limited supply of leprous blister serum 
from the burns due to thermal anaesthesia, and when this supply- 
failed me, I resorted to cantharides collodion. In our winter, so- 
called, when the temperature does not exceed 23° Cent., this blister 
serum can be kept several weeks, a solution of boric acid in glycer- 
ine being added, otherwise decomposition occurs. 

Using the same serum by intra-peritoneal injection in a guinea- 
pig, and injecting 2c.c. once a month for four months, no signs 
of leprosy showed up to the tenth month, when the animal died 
from dysentery. 

Six animals, two cats, two rabbits and two white rats, were 
given three times a week for two months 1 c.c. of leprous blister 
serum in milk per os, the gastric juice being previously alkalinized 
by the administration of 2 c. c. of liquor potassae. In the third 
month the rabbits and one cat died. In the fourth month one 
of the rats died, and on examination, the mesenteric glands and 
liver showed traces of leprous infection, the bacillus leprae being 
present. The exact cause of death I could not determine. 

At this time, the end of the fourth month, the surviving cnt 
and rat appeared apparently healthy. 



192 THE PATH OF THE DESTROYER 

Bearing in mind the excessive use of salt by many Hawaiians 
and its effect on the gastric juice (all of which I have discussed 
in previous pages), led me to imitate as far as possible the tem- 
porary alkalimzation of the gastric juice with liquor potassa, far 
more powerful and speedy in effect than sodium bicorbonate, but 
this changing of the gastric juice from acid to alkali inhibits or 
stops pancreatic secretion, which I consider aids, and is a necessary 
adjunct to favorable development of the bacillus leprae. 

I added therefore to the milk fed to the cat and rat small 
quantities of fresh pancreatic juice, expressed from the pancreas of 
the pig, when I could obtain it, as well as the leper blister serum. 

When I had no supply of fresh pancreatic juice, I used ten 
grains of the white powder, extract of the pancreas or TRYPSIN. 

At the beginning of the seventh month from the commence- 
ment of these feeding experiments, the rat showed considerable 
emaciation, loss of hair giving it a mangy appearance, a few email 
papules developed in the skin of the chest, sides of the abdomen, 
and inner surface of the thighs, the free edge of the ears showed 
decided infiltration. 

These signs of undoubted leprous infection made slow prog- 
ress, but owing to the rapid emaciation, I gave no more leprous 
blister serum, changed the rat's food to finely chopped meat, 
cheese, chopped egg, cracker, all to no effect, the animal succumbed 
the middle of the tenth month to leprous dysentery. Examination 
of the body and organs revealed leproid deposits in the liver, spleen, 
mesenteric glands, and mucosae of the ileum, with ulceration ex- 
tending into the colon and rectum. 

Sections revealed bacillus leprae in large numbers. 

Owing to lack of time, proper quarters and facilities for 
carrying on further work, and having to change my residence, I 
killed the cat, a young male, which showed leproid deposit and 
infiltration of the flanks, muscular wasting, skin atrophy, and con- 
siderable alopecia of the cheeks and forehead and abdomen, all the 
internal organs and intestines were healthy except the liver, which 
revealed leproid nodules yielding bacilli. They could also be de- 
tected in the leproid skin infiltrations. 



I spent nearly five years in the aggregate experimenting; met 
with poor success, but I gained experience. 

Cultures I never attempted, due to lack of time and skilled 
assistance. 



THE PATH OF THE DESTROYER 193 

EPILOGUE 

In the Preface of this book I have given certain reasons, 
stating how I came to write it; I now add further supplemental 
causes which influenced me to come forward and make public my 
views and experiences with leprosy. 

In the year 1909, Mr. Joseph Dutton, the venerable manager 
of the Baldwin Home at Kalawao, whom I met in the year 1886 
(when he first arrived at the Leper Settlement to take up his 
work amongst the lepers), wrote to me and asked me to write my 
experiences with leprosy. I gave him a negative answer. 

In the month of March, 1912, I received a letter from Mr. 
E. A. Mott-Smith, who filled the dual offices of secretary of the 
Territory of Hawaii, and president of the Board of Health, ask- 
ing me to supply him with certain information on leprosy, also 
advising me to go on with my leprosy investigation and write up 
the subject. I hesitated. 

I may add Mr. Mott-Smith was a most genial and tactful 
president of the Board of Health ; his education in law materially 
aiding him. He is also a great authority on leprosy and its 
prevalence. 

I believed at this time that other workers in the field of 
leprosy, of more modern education, were better outfitted and could 
do better work than I could. 

During the latter years of the late Father Wendelin's life, he 
often spoke on the subject of leprosy and its collateral bearings, 
and urged me to publish my notes and work on that disease. 

On the last day of April, 1914, when the priest's death ap- 
peared imminent to himself and his physicians, he desired me to 
promise to write my views and knowledge of leprosy for publi- 
cation, especially he besought me to give my views on Father 
Damien's case, and also to write all I knew of his life, whether 
it was favorable or unfavorable to his reputation. 

I assured Father Wendelin that if anyone could influence me 
to act as he desired, he himself could. After due reflection and 
mature consideration, I condensed and put in writing the material 
which is spread on the pages of this book. 



END OF PART TWO 



GLOSSARY 

Alii, Chief, Prince, Leader. 

Alopecia, Baldness. 

Anaesthesia, Loss of sensation. 

Anamnesis, Past history, memory. 

Anginal, Suffocative Spasms. 

Arterio Capillary Fibrosis, Thickening, narrowing of small arteries. 

Ataxia, Irregular Muscular action. 

Atrophy, Wasting. 

Axilla, Armpit. 

Bacillemia, Bacilli in the Blood. 

Bacilligenic, Caused by a Bacillus. 

Bacillus, A little stick, rod or pencil, a genus of micro-organisms. 

Bubo, An inflamed gland. 

Buccal, Pertaining to the mouth or cheek. 

Cadaver, A corpse. 

Caries, Ulceration of bone. 

Carpus, Bones of the wrist. 

Chancre, A venereal sore. 

Colon, The large intestine. 

Cystitis, Inflammation of the Bladder. 

De novo, Anew. 

Duct, Thoracic, A small canal, carries Lymph; in back of the chest. 

Duodenum, A portion of the small intestine. 

Ectropion, Eversion of the edge of the eyelid. 

Elephantiasis, Elephant-like, Leprosy. 

Endemic, Peculiar to a people or locality. 

Enter o-toxism, Poison generated in the bowels by toxins. 

Femoral, Relating to the thigh. 
Fibroid, Resembling fibers or bands. 
Flagellate, Whip-like. 
Focus, Plural Foci, central point or points. 

Gland (an acorn), A small or large fleshy mass or organ. 
Gonorrhoea, A contagious discharge from the genitals. 
Gumma, Soft gum-like nodules of Tertiary Syphilis. 
Gynaecological, Pertaining to diseases of women. 

Haole, Foreigner. 

Hawaii net, Greater Hawaii, all the islands of the group. 

Haustorium, A drawer or sucker, blood sucker apparatus of the mosquito. 

Helix, Rim of the Ear. 

Homogeneous, Like, of the same kind. 

Horripilation, Rough skin, goose skin, erection of the hairs. 

Hydrochloric Acid, HC1. 

Idiosyncrasy, Peculiarity. 

Ileum, Distal portion of the small intestine. 



THE PATH OF THE DESTROYER 195 

Impetigo, A skin disease, isolated pustules or boils. 

Infective Neuritis, Inflammation of a nerve due to presence of bacteria. 

Indigenous, Native or native born. 

Inguinal, Relating to the groin. 

Jejunum, A certain part of the small intestine. 

Kai or Makai, Towards the sea. 

Kamaaina, An old resident, a child of the land. 

Kane (k), Man or male. 

Kauka, Doctor. 

Kokua, Assistant or helper. 

Lepraphobia, Fear of Leprosy. 

Leprogen, Food or Pabulum of the Bacillus Leprae. 

Leproid, Like Leprosy. 

Leprologist, Expert on Leprosy. 

Leproma, Leprous Tumor or Nodule. 

Litmus Paper, Blue and red, it indicates alkalies and acids. 

Lochia, Uterine discharge after child-birth. 

Lichen Ruber, Skin disease, scales and small lumps or papules. 

Locomotor Ataxia, A disease of the spinal cord. 

Lux in Tenebris, Light in the Darkness. 

Lysins, Bacteria Destroyers. 

Mtfi, Sickness. 

Metacarpus, The bones of the back of the hand. 

Metatarsus, The bones between the instep and the toes. 

Mono, Single, limited to one. 

Moron, Feeble-minded, not an imbecile or idiot. 

Nanism, Dwarfed, ill developed. 
Necrosis, Death of Bone, or Soft parts. 
Nephritis, Inflammation of the kidneys. 
Neural, Pertaining to the nerves. 
Neuritis, Inflammation of a nerve or nerves. 
Nodular, Node, swelling or lump. 

Osteomyelitis, Inflammation of a bone and the marrow. 
Ostracism, Banishment from Society. 
Ovary, Female sexual Gland. 

Pabulum, Food. 

Pake, Chinese. 

Pali, Precipice. 

Pathogenic, Disease producing. 

Pathognomonic, Pointing out a Disease. 

Pectoral, Relating to the chest. 

Peripheral, Distant from the center. 

Peritoneum, Serous lining of the abdominal walls. 

Peritonitis, Inflammation of the peritoneum. 

Peyer's Patches, Lymph glands in the small intestine. 

Pilikia, Trouble in any form, or cause, etc. 

Pityriasis, A skin disease, branny scales. 



196 THE PATH OF THE DESTROYER 

Placenta, A flat cake, the after-birth. 

Pneumococcus, A globular or spherical micro-organism. 

Poi, An edible paste made from Taro, Bread Fruit, etc. 

Popolo, A Hawaiian medicine used for cough, stomach and eye diseases, etc. 

Prodromal, Approach of a disease. 

Psoriasis, Scaly skin disease. 

Psoriatic, Like psoriasis. 

Pulmonary, Connected with the lungs. 

Pylorus, The opening to the bowel end of the stomach. 

Pyaemia, Blood poisoning. 

Recrudescence, Recurrence. 

Rupia, A skin disease, blisters and scabs. 

Sclerosis, Hardening. 

Solitary Glands, Lymph glands in the small intestine. 

Spore, Reproductive element of lower Organisms. 

Sporogenous, Reproduced by Spores. 

Sputum, Matter ejected or spat out. 

Subclavian, Under collar bone. 

Syphilis, A contagious venereal disease. 

Tachycardia, Rapid action of the heart. 

Tarsus, The bones of the instep. 

Telluric, Connected with the Earth. 

Thenars, The muscles of the ball of the thumb. 

Thrombosis, A plug or clot forming in a blood vessel. 

Tinea Versicolor, Yellowish patches on the skin due to a fungus. 

Traumatic, Due to any injury. 

Trophoneurosis, Lack of nutrition, due to nerve disease. 

Tubercle, Small solid elevation of the skin. 

Tubercular, Similar to Tubercle. 

Tuberculosis, Infection of system with Bacillus Tuberculosis. 

Uka or Mauka, Inland, towards the mountain. 
Uterine, pertaining to Womb or Uterus. 

Vaccinophobia, Fear of Vaccination. 

Vagina, Female Genital Canal. 

Ventricles, Lower cavities of the heart; (right and left). 

Wahine (w), Woman or female. 




CAUCASIAN-HAWAIIAN. 



198 THE PATH OF THE DESTROY ER 



PHYSICIANS OF THE LEPER SETTLEMENT 

Year Name 

1879 N. B. Emerson (dead). 

1880-81 C. Neilson (dead). 

1882-84 G. L. Fitch (dead). 

1884-87 A. A. St. M. Mouritz. 

1888 C. A. Peterson (in office five months) ; dead. 

1888-92 S. B. Swift (dead). 

1892-1902 R. Oliver (dead). 

1902 F. H. French (in office four months). 

1902 W. J. Goodhue (holds office). 

PHYSICIANS OF THE FEDERAL LEPROSARIUM 

Year Name 

1909 W. Brinckerhoff (dead). 

1909-11 D. H. Currie. 

1911-15 G. W. McCoy. 

1915- D. H. Currie (in office). 



THE PATH OF THE DESTROYER 199 

CHRONOLOGICAL TABLE 

A. D. 

1555, Nov. 27. — John Gaetano discovers the Island of Hawaii. 

1778, Jan. 18. — James Cook re-discovers Niihau, Kauai, and Oahu. 

1779, Feb. 14. — James Cook killed at Kealakekua Bay, Hawaii. 
1785, July 22. — Ship "Lady Washington'' arrives from Boston. 
1787. — Chief Keawe Kaiana visits Canton, China. 

1788. — Chief Keawe Kaiana again visits China. 

1804, June 13. — Russian ship "Neva" arrives, introduces cholera ( ?). 

1804. — Severe epidemic ravages the islands, "Mai Okuu." 

1820, April 14. — First missionaries arrive from Kailua, Hawaii. 

1823, May 22. — Rev. C. Stewart observes lepers (?) in Honolulu. 

1827, July 7. — Roman Catholic missionaries arrive from France. 

1835. — Leprosy recognized at Koloa, Kauai. 

1840. — Mr. Brickwood observes leprosy in Honolulu. 

1848. — Dr. Hillebrand observes Chinese lepers in Honolulu. 

1850, Aug. 30. — Honolulu officially declared a city. 

1850, Dec. 13. — First Board of Health meets. 

1853, April 28. — Mormon missionaries arrive, five. 

1853, May 13. — Severe epidemic of small-pox prevails. 

1860. — Queen's Hospital erected. 

1863, Dec. 28. — First official discussion on leprosv bv Board of 

Health. 
1865, Jan. 3. — Act to prevent the spread of leprosy enacted. 

1865, Nov. 13. — Kalihi Leper Hospital opened. 

1866, Jan. 6. — Lepers first arrive at Kalaupapa. 
1873, May 10. — Fr. Damien arrives at Kalaupapa. 
1875. — Kalihi Leper Hospital closed. 

1881, Feb. 4. — Epidemic of small-pox prevails. 

1881, Dec. 12. — Kakaako Leper Hospital opened. 

1883, March 31. — Lunalilo Home opened. 

1883, Nov. 8. — Catholic sisters arrive to nurse lepers at Kakaako. 

1883, Nov. 8. — Dr. Arning, leper expert, arrives. 

1884, Sept. 30. — Keanu, the murderer, inoculated (?) with leprosy. 

1885, Nov. 9. — Kapiolani Home dedicated for non-leper girls. 

1886, July 1. — Leprologists Drs. Fitch and Arning leave Hawaii. 
1886, July 29. — Brother Joseph Dutton arrives at Kalawao. 
1888, Jan. 21. — Walter M. Gibson dies at San Francisco. 

1888, Nov. 14. — Nursing sisters arrive at Bishop Home, Kalaupapa. 



200 THE PATH OF THE DESTROYER 

1888, Nov. 19. — Fr. Wendelin arrives at Kalaupapa. 
1888. — Kakaako Hospital abolished. 

1889, Feb. 6. — Keanu arrives at Settlement from Oahu jail. 
1889, April 15. — Fr. Damien dies at Kalawao. 

1892, Nov. 18. — Keanu dies at Kalawao. 

1894, May 4.— Dr. G. Trousseau dies. 

1895, Aug. 22. — Cholera breaks out. in Honolulu. 
1895, Nov. 2.— Dr. John Brodie dies. 

1899, Dec. — Bubonic plague breaks out in Honolulu. 

1900, Jan. 20. — Chinatown swept by fire. 

1902, Aug. 12. — Dr. Oliver dies (ten years at Leper Settlement). 
1902, Oct. 9. — Fr. Wendelin leaves Kalaupapa after fourteen years' 

residence. 
1904, June 4. — Dr. Fitch, leprologist, dies. 
1909. — Federal Leprosarium opened at Kalawao. 
1909. — Dr. Robert Koch, of Berlin, visits Hawaii. 
1910. — Dr. Moses Clegg cultivates the bacillus leprae. 
1911, Feb. 23. — Cholera again invades Honolulu. 
1911, Oct. 27. — Alleged case of yellow fever at Kalihi. 
1912. — Dr. G. A. Hansen dies, discoverer of bacillus leprae. 

1914, Sept. 1. — Fr. Wendelin dies. 

1915, June 7. — Charles R. Bishop dies, founder of Bishop Home 

for girls. 

1915, June 22. — Rev. F. W. Damon dies, spiritual worker amongst 

Chinese lepers. 

1916, Jan. 6. — High Chiefess Grace Kahoalii dies; semper fidelis. 

1916, March 18. — W. E. Rowell, C. E., dies, a man of noble char- 
acter ; his companions through life were faith, 
hope and charity. (He taught the author the 
Hawaiian language.) 



PART III. 



PERSONAL REMINISCENCES 



A RESPONSIBLE OFFICE 

In connection with the transfer of the first shipment of orphan 
girls from Kalaupapa to the Kapiolani Home, which I have des- 
cribed in a previous chapter, occurs the name of Ambrose Hutchi- 
son, deputy or resident superintendent of the Settlement, an office 
of great responsibility, for upon his shoulders fell all the burden 
of the management and general conduct of everything pertaining 
to the affairs of the Leper Colony on Molokai. 

Mr. Hutchison held office for fourteen years, 1884 to 1897 — 
although a victim of neural leprosy, and often rendered unfit by 
exacerbations of leprous fever and other ailments that followed 
the progress of the disease in his system — he stuck manfully to his 
post, and often alone and unaided met serious and unforseen diffi- 
culties with commendable foresight and judgment, and just as 
often a certain other official claimed all the credit that was due to 
Ambrose Hutchison. 

Mr. Hutchison is a Caucasian-Hawaiian, and now ranks as 
the second oldest resident, having arrived at Kalaupapa in the 
month of January, 1879, his period of residence has reached over 
thirty-seven years. His malady first showed itself about the year 
1868, so that he has had leprosy FORTY-EIGHT YEARS. For 
many years he has been free from the ravages of the disease, which 
.shows apparently the exhaustion of the pabulum or leprogen in 
the tissues necessary to the sustenance of the bacillus leprae, or 
the non-activity of his disease may be due to the production of 
lysins which have destroyed the reproductive powers of the bacilli. 

When I resided at Kalawao (1884), Mr. Hutchison was 
quite a young man (in his twenties), yet he displayed marked 
ability and highly creditable administrative powers for a man so 
young. I repeat the responsibility of his office was great. In those 
days the steamer and mail service were not of the best, and the 
facilities for landing freight at Kalaupapa were of a negligible 
quality, boat after boat would be overturned in the surf ; the water 
supply was poor and scanty — a three-quarter inch pipe being the 
delivery for 800 people. 

Mr. Hutchison being the resident official, executive and rep- 
resentative, was the target for all the growlers and kickers, he 
steered his way, however, through the various problems that came 



204 THE PATH OF THE DESTROYER 

up from time to time in a manner that would have done credit 
to much older heads. 

For acting as superintendent, sheriff, purveyor, and supervisor 
of all the details of the civil administration, he was paid the muni- 
ficent salary of $30 per mensem! 

This same office today pays its holder with perquisites $400 
monthly, and there is less responsibility at the present time than 
there was thirty years ago, because the act of a present-day super- 
intendent is the direct, act of the Board of Health. This body 
directs the policy of that official, whereas when Ambrose Hutchi- 
son held office, he himself was the author and originator of any 
policy laid down and pursued. 

The Board of Health's direct policy only came into existence 
with the inauguration of a resident superintendent in the year 
1897, on the decease of Meyer. 

In replying to my request for his life history, Mr. Ambrose 
K. Hutchison wrote me as follows: 

Kalaupapa, Molokai, 
Nov. 6, 1914. 

In compliance with your request to give you the particulars 
about myself. It is with great reluctance that I take my pen to 
write about this matter, for it recalls to memory the pathetic side of 
my life as a Condemned outcast and Prisoner. 

That you are not asking me about my life history from mere 
curiosity, but for scientific research, and knowing well your ability 
to carry on the same into the dreadful malady, which has been such 
a virulent scourge of the Hawaiian people, without any sign of 
abatement after many years of vigorous segregation ; having gathered 
the knowledge in your practice among the people here and else- 
where to write on such a subject, for that reason, I without reserve 
willingly give you a history of my case. 

(Signed) A. K. Hutchison. 

I herewith reproduce Mr. Hutchison's Autobiography. 

"Thirty-five years ago, I and eleven other fellow unfortunates 
were marched from the leper detention station, adjoining the old 
police station on King street, a little Ewa of Nuuanu street, 
through the streets of Honolulu, guarded by policemen, down to the 
Esplanade, and put on board the little coasting steamer "Mokolii" 
bound for Kalaupapa, with the Hon. S. G. Wilder, president of the 



THE PATH OF THE DESTROY ER 205 

Board of Health, and Dr. N. B. Emerson, newly appointed resident 
physician for the Leper Settlement, as passengers. 

We arrived at Kalaupapa Sunday morning, January 5, 1879. 
After landing, our names, ages, and places hailed from were taken 
down by the Settlement officials; we were left on the rocky shore 
without food or shelter. I had to accept the shelter and hospitality 
of a friend living at Makanalua about a mile and a half inland from 
the landing, hence my building a house and taking up my residence 
there, which has been my home until recently, when I moved to 
Kalaupapa. 

All those fellow passengers that landed with me have passed 
away, and I am the sole survivor and the longest living resident, 
save Hoolemakani (w), she has been a resident since the founding 
of the Settlement in the year 1866. 

My connection as an employee of the Board of Health com- 
menced November 1, 1881, when I was put in charge as chief 
butcher and beef dispenser. On September 25, 1882, I was pro- 
moted to the position of head storekeeper of the Board of Health 
store at Kalawao. I made good and gave satisfaction. 

On March 8, 1884, I was appointed and given full charge of 
the Settlement, filling the position of resident superintendent, and 
continued uninterruptedly in the management until the close of the 
year 1889, when I was officially informed of the appointment of 
Mr. T. E. Evans, as superintendent who was to take charge on 
January 1, 1890. 

When Mr. Evans paid his first official visit, I of course tendered 
him my resignation. He refused to accept it, and asked me to 
continue in office as his assistant, which I did, but shortly after 1 
was struck down with paralysis and my recovery was despaired of, 
but due to the devotedness of my late beloved wife, and the care 
I received, together with the medicine furnished me by my good 
friend, the late Dr. George Trousseau, I recovered, after undergoing 
great physical agony. 

Mr. Evans resigned after his trouble with the lepers who as- 
saulted him; he was succeeded by Mr. W. H. Tell, but before a 
year had passed, he also had some trouble which displeased the Board 
of Health, and I was asked to assist Mr. Tell. I was then convales- 
cent enough from my severe illness to be able to work, but my as- 
sistance did not save him, for the Board voted to remove him from 
office. 

On the 19th of October, 1892, I was again put in charge and 
continued with the management until December 31, 1897, when 



206 THE PATH OF THE DESTROY ER 

I resigned and declined further work, and went out of office at the 
above date. I served the Board of Health faithfully for fourteen 
years, giving the best that was in me to fill the arduous duties of 
my office. 

MR. HUTCHISON'S AFFLICTION— NEURAL LEPROSY 

I must have had neural leprosy ten or twelve years (about 
1868) before my banishment to Molokai. The first symptoms I 
noticed were, absence of feeling over my right, knee cap, either to 
touch, pinching or needle prick, the loss of sensation gradually 
spread down to the ankle and foot; shortly after my left knee, 
ankle and foot became affected, devoid of feeling; boils broke out 
simultaneously on both knees. The color of the skin remained 
natural, but presented a harsh, dry appearance, at this time dif- 
ficulty of breathing through my nose manifested itself, especially at 
night, and when sleeping. 

I next noticed the wasting of the ball of my right thumb, and 
the web between the thumb and index finger, ring worms appeared 
on my face and neck, the soles of my feet began to harden, and 
the skin became fissured, forming sores and deep ulcers down to 
the bone, which healed with difficulty. 

I next noticed the wasting of my left hand, and the muscles 
of both arms, the skin of my forehead seemed drawn excessively 
tight, gradually all the symptoms I have mentioned progressed at 
an even pace and very slowly. My present condition, — I am 
physically maimed and weak, and a wreck to what I was before 
the attack of paralysis laid me low. I am without pains, sores, or 
ulcers on any part of my body, my hands and feet are much muti- 
lated from the ravages of the disease in the past. I think the 
leprosy has exhausted itself in my system. 

I have no relatives living or dead who have had leprosy, I 
have never lived with lepers until I came to Molokai. 

My boyhood was spent in a boarding school in Honolulu, 
under the tuition of Archdeacon George Mason. I was born at 
Honomaele, Hana, Maui, and I am 58 years old. 

I have never had a true mother's care. When I was a month 
old I was given away to my mother's sister, — she was widely known 
and famed amongst the Hawaiians as a expert kahuna or doctor, 
well versed in the use of herbs and treatment of sickness. 

I have a faint recollection of a man with large ears and bloated 
face, swollen hands and feet, who used to come to the house where 



THE PATH OF THE DESTROYER 207 

we lived to be treated by my foster mother. This man's disease 
in after years I realized was leprosy. I may have become a leper 
from contact with this man. I also was vaccinated with the matter 
or lymph taken from another boy's arm, from either of these 
sources of contagion I believe I contracted leprosy, or it. may have 
been from other unknown sources. 

(Signed) A. Hutchison." 

Mr. Ambrose Hutchison's history of his life is highly enlighten- 
ing and interesting, and brings out the following points. 

1. The remarkable duration of his malady, 48 years. 

2. The harshness and hardship of his transportation. 

3. His noble resignation to his hard fate, 36 years in con- 
finement and banishment from the outside world. 

4. The suspicion and life long idea that vaccination may have 
been the cause of his contracting leprosy. 

5. His contact with a Leper at his Mother s house. I men- 
tioned in previous pages that contact with a leper has occurred in 
almost all cases of leprosy; on careful investigation, and inquiry 
this history can nearly always be obtained. There is no possibility 
of a de novo development of leprosy. 

Mr. Hutchison states he was landed at Kalaupapa, and practi- 
cally dumped on the shore, no provision being made for the re- 
ception of himself and fellow passengers. This shiftless and dis- 
graceful neglect no longer exists, the fault lay with the Honolulu 
authorities, who persistenly failed to notify in advance the Molok:;i 
officials of the coming of a new consignment of lepers. 

This unpreparedness of the officials to receive newcomers 
worked an injury to the enforcing of segregation, and caused the 
leper to dread being taken to Molokai, also fake information was 
spread all over the Islands about lepers dying immediately after 
being landed at Kalaupapa. This has happened when the leper 
was in a very exhausted condition, both from the advanced state 
of his disease and from sea-sickness. Bearing on this matter I re- 
late two cases. 

In our winter months when the north wind prevails, accompa- 
nied with driving rain, the temperature falls on Molokai as low 
as 58° F. ; this condition of the weather, together with the thin and 
scanty clothing generally worn by the inhabitants of Hawaii, makes 
a sick person feel cold, and is liable to induce pneumonia. 

On one such night, with similar weather conditions described 



208 THE PATH OF THE DESTROYER 

above, there arrived at Kalaupapa about midnight the steamer 
"Mokolii" with freight, and about forty leper passengers. 

There was a heavy surf breaking, the wind was from the 
North and a driving, chilly rain was falling. 

If it were not for the able handling of the small boats by 
the Hawaiian seamen (among the best in the world), they would 
have been swamped, overturned and broken to pieces on the rocky 
shore. By a miracle, none of these disasters occurred, and both 
freight and passengers landed in safety, the latter drenched to the 
skin by rain and sea. 

No advices had been sent, in advance of any intention to ship 
lepers to the Settlement, but the officials were not caught unpre- 
pared, both Father Damien and Mr. Ambrose Hutchison had 
steaming hot coffee and warm food for all who were landed. (The 
date of this was January, 1885.) 

"LITTLE MARY" 

I was at the landing, waiting in the lee of the freight house, 
sheltered from wind and rain, when I was accosted by a diminutive, 
girlish figure, asking if I was Father Damien, as she carried a let- 
ter from the Sisters at Kakaako detention station ior him. This little 
girl, not full ten years old, told a pitiful story — she was soaked to 
the skin with rain and sea, and shivering with cold, was anxious to 
get food, shelter and a place to sleep. She was self-possessed, in- 
formed me her father had died on the steamer, and was buried at 
Pukoo, a port of the lee side of Molokai; also on the steamer, too 
ill to be landed was her little brother 6 years old, who was a leper 
as well as this little girl herself. 

I speedily passed her along to Father Damien and some kokua 
women, who fed and warmed the child and gave her dry clothing. 
Her brother was landed at daylight much to the child's delight. 

This little girl's name was Mary, and her great dread and 
worry was that she would have no house to shelter her, hence the 
letter to Father Damien from the Sisters asking him to exercise his 
good offices in getting this family settled. 

The "Mokolii' could and ought to have made direct trips from 
Honolulu to Kalaupapa, but the Board of Health in their (?) wis- 
dom did not see the necessity of this, hence the steamer made the 
whole circuit of the island of Molokai before coming to Kalau- 
papa. This arrangement caused untold misery and suffering. The 
S. S. Mokolii was small, 96 tons burden, (under the old method 



THE PATH OF THE DESTROYER 209 

of measurement) had no accommodation for passengers well or sick, 
excepting on deck. This vessel was far from speedy, could steam 
6 knots per hour, had a free-board of 3 feet, yet this miserable 
little tub of a steamer was kept on the Molokai route for fully 25 
years. 

This little girl Mary, kept repeating to me her dread of be- 
ing left out in the dark and cold, with no house for shelter. 
Later on, I asked the child who told her this, she answered, 
"Father and other people." Mr. Hutchison's experience on land- 
ing was evidently the rule, and not an isolated exception, the con- 
ditions attendant thereon must have been wide spread and known 
all over the Islands. 

"NAOMI" 

Here again is another case bearing on this point. Naomi, a 
Hawaiian woman afflicted with leprosy, lived for ten years in the 
forest between Wailau and Halawa, Molokai, leading a life of 
terror and anxiety, fearing that at any moment the police would 
find her. 

The great and ever present fear of Naomi was separation from 
her husband, and then having no one to take care of her, and no 
house to shelter her at the Leper Settlement. 

This woman informed me she would have given herself up and 
surrendered voluntarily, were it not for stories which she had 
heard from others about certain conditions at the Leper Settle- 
ment, viz., paucity of houses, the first comers filling all the houses, 
and later leper arrivals having to seek shelter on lanais, under 
walls or trees, no one to pound poi, or get food or wood for fire 
and cooking purposes. 

About the year 1902, Naomi's leprosy (which she had had 
about 12 years) had progressed to the extent that it had destroyed 
her hands and feet, and also her eyes, — she was helpless, — her fingers 
and adjoining metacarpal bones, also her toes and the metatarsi had 
all been removed by slow sloughing and necrosis. Her husband 
was devoted to her, fortunately they had no children. Owing to 
the necessity of seeking food, the poor shelter from the rain and 
cold wind that a residence in the mountain forest entailed, and 
the exhausted condition of Naomi, the husband decided to move 
her into the Halawa valley ; there on the hill side, in a lantana 
thicket, he built a small grass house for her, and shortly after she 
was arrested there by the police of Molokai on information fur- 
nished bv an enemv of the familv. 



210 THE PATH OF THE DESTROY ER 

Naomi's condition was very pitiful, the leprosy had ravaged 
her body as I have before described, and she was bedridden and 
totally blind, yet her husband quietly and respectfully asked me 
not to separate them, stating that he would look after her as long 
as she lived, and he would allow no person to come to the house 
or its surroundings. 

I told the husband and Naomi that the Sisters at the Bishop 
Home would receive her and care for her, and where she would 
want for nothing. 

On thinking the matter over, I decided that Naomi was so 
weak and exhausted, that there was every prospect of her death 
on the steamer in transit to Honolulu. 

I notified the Board of Health, they accepted my view, and 
Naomi remained where she was, the husband devotedly caring for 
her until her death, and living faithfully up to his promise to allow 
no visitors on his premises. 



Throughout the pages of this book I have frequently brought 
up the subject of the hostility manifested towards segregation to 
Molokai, some of the objections and complaints are only too well 
founded. 

The question of transportation to Kalaupapa from Honolulu 
has never received the attention it should, the method pursued is 
practically the same as it was nearly fifty years ago. 

I introduce here part of a letter I wrote to the editor of the 
Pacific Commercial Advertiser and published June 21, 1914. 

TRANSPORT OF LEPERS NOT THE BEST 

"There is a decided need for improvement in transporting the 
sick to Molokai. On April 30 ult. forty-nine lepers were taken 
from Kalihi to Kalaupapa. The accommodation provided for them 
was the steamer's deck, crew and leper mixing of their own sweet 
will. 

These unfortunate people were landed at night on a surf- 
bound, rocky shore, and treacherous landing. The same conditions 
of transport have been in operation forty-eight and a half years." 



A PERSONAL EXPERIENCE 

THIRTEEN YEARS' RESIDENCE AND LABOR AMONG 
THE LEPERS AT KALAUWAO 

BY 

REV. JOSEPH DAMIEN, CATHOLIC PRIEST. 

By special providence of Our Divine Lord, who, during His 
public life showed particular sympathy for the lepers, my way 
was traced towards Kalauwao in May, A. D. 1873. I was then 
33 years of age, enjoying a robust, good health — Lunalilo being at 
that time King of the Hawaiian Islands, and His Excellency E. 
O. Hall, president of the Board of Health. 

A great many lepers had lately arrived from the different 
islands; they numbered 816. Some of them were old acquaintances 
of mine from Hawaii, where I was previously stationed as a mis- 
sionary priest ; to the majority I was a stranger. 

The Kalaupapa landing-place was at that time a somewhat 
deserted village of three or four wooden cottages, and a few old 
grass houses. The lepers were allowed to go there only on the 
days when a vessel arrived ; they were all living at Kalauwao — 
about eighty of them in the hospital, in the same buildings we see 
there today. All the other lepers, with a very few kokuas (help- 
ers), had taken their abode further up towards the valley. They 
had cut down the old pandanus, or puuhala groves, to build their 
houses, though a great many had nothing but branches of castor 
oil trees with which to construct their small shelters. These 
frail frames were covered with ki leaves (Dracaena terminalis), 
or with sugar-cane leaves — the best ones with pili grass. I my- 
self was sheltered during several months under the single pan- 
danus tree, which is preserved up to the present in the church- 
yard. Under such primitive roofs were living pell-mell, without 
distinction of ages or sex, old or new cases, all more or less 
strangers one to another, those unfortunate outcasts of society. 
They passed their time with playing cards, hula (native dances), 
drinking fermented ki-root beer, home-made alcohol, and with the 
sequels of all this. Their clothes were far from being clean and 
decent on account of the scarcity of water, which had to be brought 
at that time from a great distance. 

The smell of their bodies, mixed with exhalation from their 



1 



■' 
















FATHER DAMIEN, 
Aged twenty-six years. 



THE PATH OF THE DESTROYER 213 

sores was simply disgusting and unbearable to a new-comer. Many a 
time, in fulfilling my priestly duty at their domiciles, I have been 
compelled not only to close my nostrils, but to run outside to 
breathe fresh air. To protect my legs from a peculiar itching 
which I usually experienced every evening after my visiting them, 
I had to beg a friend of mine to send me a pair of heavy boots. 
As an antidote to counteract the bad smell, I made myself accus- 
tomed to the use of tobacco, whereupon the smell of the pipe pre- 
served me somewhat from carrying in my clothes the obnoxious 
odor of the lepers. At that time the progress of the disease was 
fearful, and the rate of mortality very high. 

These are a few of my recollections of what I have seen and 
experienced at the beginning of my labor here. The miserable 
condition of the Settlement at that time gave it the name of a 
living graveyard, which name I am happy to state, and hope to 
prove hereafter, is today no longer applicable to our place. 

From the accession of King Kalakaua to the throne up to the 
present time, His Majesty's Government, assisted by Christian 
charity, has endeavored, little by little, according to means and cir- 
cumstances, to improve the situation of the lepers, and to make 
them more comfortable. 

Consulting my own observations and experiences only, without 
any memorandum book or register, I intend to show here what 
contributes much towards the comforts and benefits of lepers, and 
what is obnoxious or injurious to them, and will prove these two 
statements by putting our good situation and comfort in parallel, 
with what I found here at my arrival, as already explained. 

THE DIET OF THE LEPERS 

The food on which a leper has to live exercises a great in- 
fluence on the disease. Our Hawaiian taro, containing a great 
quantity of starch, and being easy of digestion, is our best vegetable. 
So far, I have never seen any bad effects from it, even in fevers 
and other temporary ailments to which our lepers are so often 
subjected to. Hawaiian people in general, but especially our lepers, 
cannot go well without it. I remember that, some ten years ago, 
the place having been about three months without taro on ac- 
count of the scarcity of that vegetable, several deaths occurred in 
consequence of it, and the majority of the people looked emaciated, 
although they had plenty of rice and sweet potatoes. 

The administration having to supply weekly from six to seven 



214 THE PATH OF THE DESTROYER 

hundred people, each with twenty-one pounds of cooked taro, a few 
words concerning the manner how it is obtained may be desirable. 

At the northern side of Molokai are three large valleys, viz., 
Halawa, Wailau, and Pelekunu, in which the cultivation of taro is 
the chief business of a considerable number of natives. On them 
especially we have to rely for our regular supply. The high cliffs 
preventing all overland road traffic, the cooked taro, or paiai, has 
to be brought by sea either in open boats or a small schooner, as 
was done from the beginning, or in a small steamer latterly. 

The steamer's service has been highly appreciated by the public 
on account of its regularity, schooners and boats being often pre- 
vented by calm or rough weather from arriving when the food is 
wanted ; unavoidably, our people are then deprived of their good 
poi, which is left to rot where it was cooked, causing great loss to 
all concerned. If poi cannot be obtained, the issue of rice or 
hard bread takes its place, of which there is always a certain 
quantity on hand, though it is recognized that, with the exception 
of the Chinese, neither native nor foreigner could live on rice as 
principal food. 

A certain number of our people, with their more or less mu- 
tilated hands, succeed in raising a few sweet potatoes, which answer 
well for a change in the diet, or in case of emergency. Unfor- 
tunately some of our Hawaiians are much addicted to the use of 
a certain beverage made of sweet potatoes, which they allow to 
ferment, and thus obtain an obnoxious, intoxicating drink. They 
are very fond of it, but it makes them excited, and has a bad 
effect on their system, as have all other alcohols; and I wish to 
express here my sincere thanks to our local administration for having 
wisely prohibited the use of it. 

Besides their regular food, a pint of good milk provides them 
advantageously with a wholesome, nourishing beverage in the line 
of diet. The question naturally occurs to the mind of the reader, 
how can a sufficient quantity of milk to supply such a number of 
people be procured? May I be allowed to explain my views on 
this. 

This Settlement, in the greatest, part, affording the best kind 
of grazing for stock, I would suggest to the administration with 
all my might to increase as much as possible the number of good 
milch cows. UNFORTUNATELY, ON ACCOUNT OF THE 
GREAT AMOUNT OF MEAT WANTED, ABOUT FIVE 
THOUSAND POUNDS A WEEK, AND THE FREQUENT 
FAILURE OF THE ARRIVAL AT THE REGULAR TIME 



THE PATH OF THE DESTROYER 215 

OF BEEF CATTLE, OUR BUTCHERS ARE SOMETIMES 
OBLIGED TO KILL OFF MORE OR LESS OF OUR 
VALUABLE MILK STOCK, WHICH KEEPS THE LAT- 
TER ON A DECREASE, AND THEREFORE LESSENS 
TERRIBLY THE SUPPLY OF MILK. 

Let me regretfully state, it is now several years, up to the 
present day, that not one-tenth of our lepers outside of the hospital 
yard have been enabled to enjoy the benefit of a small daily supply 
of milk. 

I beg leave to be allowed to make here a suggestion for the 
benefit of the Board of Health and for the lepers. May it be 
proposed at the next Legislature to make, besides the regular appro- 
priation for the support of the lepers, an additional one, such as 
to provide the necessary means for buying at once as many head 
of cattle as our beautiful plain for grazing can support, — say from 
500 to 1000 head, of which a certain number should be used for 
breeding and milk, and the rest for beef cattle. In regard to 
salmon, as a substitute for meat, I simply will state that it may 
do once in a while, but the less the better. 

THE WATER SUPPLY OF THE SETTLEMENT 

From the landing-place of Kalaupapa up to Kalauwao we 
have no regular water stream. Fortunately, at the upper part of 
the Kalauwao valley there is one, but the water is not very abun- 
dant, though sufficient, if properly managed, to supply this one 
village. When I first arrived here the lepers were obliged to carry 
their water in oil cans from that gulch on their shoulders, or on 
horses, under the greatest difficulty; there also they used to wash 
their clothes. The scarcity of water at that time accounted, to 
some extent, for their living very dirty. 

In the summer of A. D. 1873, we received some water pipes, 
and all our able lepers were only too willing to help in laying 
them, and in building a small reservoir. Since then Kalauwao 
has been well supplied with good water for drinking, bathing, and 
washing, and has been proved to be a better place for living than 
Kalaupapa, where the people continue to resort to rain or brackish 
water, and in dry seasons they are obliged to come to Kalauwao 
for it. 

On studying this question of water supply, I was informed 
that at the terminus of the valley called Waihanau (water arise), 
which valley is located a little more than one mile southeast of 



216 THE PATH OF THE DESTROYER 

Kalaupapa, there is a natural reservoir. At one time in company 
with two of our intelligent white men and some of my boys, I went 
to investigate the truth of it, and, after two thousand feet of 
travelling in the gulch, we arrived at this truly beautiful reservoir, 
built by Nature's hand in the form of a circular basin; its diameter 
in one direction is 72 feet, and 55 in the other. 

On sounding its depth we found twelve feet of water at a 
short distance from the bank, and eighteen feet towards the center. 
The water being ice-cold, none of my boys dared to swim across to 
ascertain its true depth close to the high cliff, where probably it is 
deeper. The water looks very clear and has an excellent taste. I 
should remark here the statement which a native, who, during the 
period of ten years, has made it his business to deliver water to 
any part of Kalaupapa for a certain fee, made to me, viz. : "That 
if no other source in the vicinity affords any water during very 
dry seasons, this basin has never failed to furnish any amount 
needed." The above statement was acknowledged to be true by a 
great many more of the old residents who had seen that reservoir 
and confirmed it. This, and the large overflow in connection with 
the drainage from above, leaves me to conclude that there must be 
a large feeding source below. This reservoir is perfect and per- 
manent in itself, without incurring any expense or labor. 

Now, instead of going to Waikolu to obtain a water supply 
for Kalaupapa, as was intended, which would be besides the diffi- 
culty of labor of building a reservoir and for laying from such a 
distance, say over five miles, the amount of pipe required for that 
purpose, a very large expense to the Government, therefore I simply 
recommended the laying of good pipe from this Waihanau reservoir. 
The question of supplying water for Kalaupapa has been for a 
long time under discussion, and never thoroughly investigated, 
under the impression that it would cost too much, and there the 
matter rests at present. 

My desire being to see the work carried on without any fur- 
there delay, once I was sure of getting this supply of beautiful 
water at a comparatively short distance, and wishing to give all 
information necessary, I have taken the pains to measure the exact 
distance, which I found to be from the reservoir to the Kalaupapa 
store-house thirteen thousand six hundred and eighty (13,680) feet. 
All this distance is on an uninterrupted, gradual decline; and 
having on hand a better reservoir, and a surer supply of water than 
we have at Kalauwao with a 2-inch pipe for half the distance, and 



THE PATH OF THE DESTROYER 217 

1^-inch for the remaining part, without a doubt the Kalaupapa 
village can be abundantly supplied with good, pure water. And 
having here a man capable of executing such a work, with many 
hands to assist him, I think that the expense above the cost of the 
pipe would be but a trifle. 

THE DWELLINGS OF THE LEPERS 

Good ventilation being in general one of the first conditions 
of hygiene, it is much more necessary for our lepers, on account of 
the foetid exhalations from them being much greater than from 
any other disease. 

In previous years, having nothing but small, damp huts, 
nearly the whole of the lepers were prostrated on their beds, cov- 
ered with scabs and ugly sores, and had the appearance of very 
weak, broken-down constitutions. In the year 1874, the great 
question was how to improve the habitations of the unfortunate 
people, the Government appropriation being at that time barely 
enough to provide them with food? 

During that winter a heavy south wind blew down the ma- 
jority of their half-rotten abodes, and many a weak leper laid 
there in the wind and rain, with his blanket and clothes damp and 
wet. In a few days the old grass beneath their sleeping mats began 
to emit a very unpleasant vapor. I at once called the attention of 
our sympathizing agent to the fact, and very soon there arrived 
several schooner loads of scantling to build solid frames with. All 
the lepers who were in distress received, on application, the square 
laths to thatch the grass or sugar cane leaves to. Afterwards rough 
N. W. boards arrived, and also the old material of the former 
Kalihi hospital. From private and charitable sources we received 
shingles and flooring. Those who had a little money hired their 
own carpenters; for those without the means the priest, with his 
leper boys, did the work of erecting a good many small houses. 
Besides, some new comers who had means built their dwellings at 
their own expense. 

In 1878, after the inspection of the Settlement by a special 
committee, of which Your Excellency, then a member of the As- 
sembly, was chairman, sent by the Legislature to Kalauwao, the 
Board of Health having obtained a larger appropriation by a special 
recommendation of that committee, at once erected a good many 
comfortable houses, and also provided several other comforts for 
the lepers, of which they were greatly in need. 



218 THE PATH OF THE DESTROYER 

Lime has always been supplied by the Board of Health gra- 
tuitously for whitewashing the cottages, and thus, little by little, 
at comparatively small expense to the Government, combined with 
private and charitable resources, were inaugurated the comfortable 
houses which constitute today the two decent-looking villages of 
Kalauwao and Kalaupapa. I estimate the number of houses at pres- 
ent, both large and small, somewhat over three hundred, nearly all 
whitewashed and, so far, clean and neat, although a number of 
them are not yet provided with good windows. These houses, of 
course, cannot have the proper ventilation they need, and naturally 
create an unpleasant and unhealthy smell ; I therefore humbly pray 
that the Board will be kind enough to take steps and see that this 
still-existing evil be soon remedied. In conclusion, I am happy to 
remark that, if I compare the present with the past, the unfortunate 
people of today are not only more comfortable and better off in 
every respect, but their disease in general is a great deal milder and 
less progressive, and, in consequence, the death rate is not so high. 
This is greatly due to the improvement in the houses. 

THE CLOTHING OF THE LEPERS 

The Settlement being situated at the northern side of the 
island, and backed at the south by very high and steep mountains, 
the climate is naturally cool. The winter season brings forth 
generally a long spell of cold weather. The disease, too, at a 
certain stage, interferes much with the free circulation of the 
blood, and therefore our lepers often complain of cold. Those 
who have suitable and warm clothes to protect themselves from the 
inclemency of the weather resist it generally very well, but for 
those who, through neglect or destitution, have barely enough to 
cover their nakedness, the cold and damp weather has a bad effect. 
They then begin to feel feverish and cough badly; swelling in the 
face and limbs sets in, and if not speedily attended to the disease 
generally settles on the lungs, and thus hastens them on the road 
to an early grave. On my arrival I found the lepers in general 
very destitute of warm clothing. So far they had received from 
the administration a suit of clothes and a blanket; but some of 
them being very neglectful and filthy, in a few months nothing 
remained but rags. Those who had friends in the outer world 
were fortunate in receiving from time to time a few articles '»f 
clothing, but the friendless and the poor suffered greatly. There 
was no store at the time within the limits of the Settlement where 



THE PATH OF THE DESTROYER 219 

they could buy a few garments or other necessaries, and those who 
received or could earn some money had to entrust it to the captain 
of the schooner to buy for them what they were in want of. 

We all greatly felt the necessity of a suitable market store, 
and, on a very sound principle, the Molokai store was inaugurated 
by the Board of Health in the summer of 1873. To start with, a 
thousand dollars out of the appropriation was invested to lay in 
the first stock, and with a certain percentage above the cost price 
to cover current expenses, the store has since then been running 
on its own account, supplying our people with any article they may 
wish to buy. Each year the the Board issues an order for six 
dollars to each leper to enable them to buy at the said store what 
they are in need of, especially in the line of clothing. So far, this 
store has proved to be a success and a great convenience to the 
people here, and we could not do very well without it. 

Besides the allowance by the Board of Health, Christian 
charity has given us a helping hand in the matter of clothing, and 
assisted us to our great satisfaction. In previous years it was 
nothing unusual to receive from time to time a cart-load of clothing 
for distribution to the needy; for instance, such as were received a 
year and a half ago from the hands of Her Majesty Queen Kapio- 
lani, and those who assisted her in filling the leper subscription. 
Thanks for the aid in the past. May the future prove that untir- 
ing perseverance of charity continues to assist the Board of Health 
in supplying the unfortunates of Molokai with all their necessities; 
especially with warm clothing, because, may I here remark, that 
the yearly allowance of six dollars to provide clothes and other 
indispensable articles is quite insufficient for those who have no 
private means, and no friends Or relatives to give them a helping 
hand. I beg to lay this statement, based on a long experience, be- 
fore the honorable Board of Health for future consideration. 

The allowance granted by the Board, combined with Christian 
charity and some private industry, of which I intend to speak 
hereafter, has greatly ameliorated the condition of our lepers and 
provided them with comparatively good clothes. 

EXERCISE FOR THE LEPERS 

Leprosy is a constitutional disease by which, generally, the 
circulation of the blood is partially obstructed, the nerves and 
muscles more or less paralyzed, and the limbs are often disabled 
in one place or the other, which varies in almost every case. 



220 THE PATH OF THE DESTROYER 

A person afflicted with leprosy, who quietly gives himself up 
to the ravages of the disease and does not take exercise of any 
kind, presents a downcast and sloughy appearance, and threatens 
soon to become a total wreck. Therefore exercise, as a daily 
occupation, is highly commendable to invigorate the system, giving 
a fresh impetus to the general movement, of the muscles and to 
the free circulation of the blood, thus averting many pains, sores, 
and other consequences of a prostrated constitution. 

In former days (from 1866 to 1873), all the lepers being 
collected at the rather small village of Kalauwao, the majority jf 
them passed their time in sleeping, drinking, and playing cards, 
while only a few others cultivated the fields; and horses being 
limited at that time, a minimum number only of the inmates could 
enjoy the exercise of a horse-back ride. 

Later on, all that tract of land at Kalaupapa having been 
annexed to the Leper Settlement, traveling was at, once increased to 
a great extent; going from one village to the other became not only 
a healthful exercise and pleasure, but of a frequent necessity; 
horses too have increased, and are easily procured. This tract in- 
cludes a very fertile piece of cultivable land — over two hundred 
acres are fenced in along the foot of the mountains. Every leper 
is privileged to occupy any vacant portion of it he may choose 
to cultivate, as some were already accustomed to do in the Kalau- 
wao fields. 

Traveling on foot, riding on horseback, and cultivating the 
soil are the most healthy occupations of our lepers. Let me, there- 
fore, bring to notice that, up to the present date, about nine-tenths 
of the entire population are enjoying these invigorating occupations 
and exercises, while previously only about one-tenth could do so. 
Such daily exercises as can be obtained here does not only strongly 
aid in checking the disease in its rapid progress, but also averts 
many ailments which otherwise might befall the victim. Induce- 
ments of this kind, in regard to daily exercise for the welfare of 
all afflicted which this Settlement affords, cannot likely be gotten 
up in any other asylum in the world. 

In regard to the wholesome exercises obtained by cultivating 
the soil, a few facts showing how it has been and should con- 
tinue to be encouraged, may here be brought under observation. 
Soon after that piece of land mentioned above had been put at the 
disposal of the lepers, many whose hands were not too much 
mutilated began at once to plant a patch of sweet potatoes, and very 
soon had an abundant crop. 



THE PATH OF THE DESTROY ER 221 

During the winter when the boats which had to supply the 
Settlement with taro were prevented from arriving on account of 
the bad weather, the local administration was fortunate enough to 
get a weekly supply of sweet potatoes from those who had a 
quantity at their disposal, and thus not only prevented a temporary 
famine, but the money usually paid to the outsiders for paiai was 
paid into the hands of our lepers, and, little by little, money came 
into circulation among the poor people. This being a great en- 
couragement, very soon the majority had some potatoes of their 
own planted, and shortly afterwards they petitioned the local 
administration to obtain instead of their weekly rations its equiva- 
lent in money. This having been granted, numbers of lepers availed 
themselves of this opportunity to obtain some cash to buy their 
little necessaries with. 

This system of paying money, instead of giving the weekly 
supply, continued for about eight years, varying in amount accord- 
ing to the- harvest of sweet potatoes, and sometimes through the 
deficiency of taro. Besides the great benefit of a healthy exercise 
for the sick, their monthly ration money not only alleviated the 
condition of those who availed themselves of it, but brought money 
into circulation, and created between the two villages many other 
kinds of small industries. 

The Leper Settlement store, too, at that time had a larger 
business, because there was money in the hands of the people, who, 
in general, called there to provide for all their different needs. 

Up to within recently the people were in comparative ease at 
the Settlement, but at present the system of paying the equivalent 
of rations, on account of abuses having been taken away, though 
they have enough to eat, they are, nevertheless, getting in very poor 
circumstances. This system was very beneficial for the health and 
comfort of the lepers, as I have shown, and not any more expensive 
to the Board of Health, therefore, in the interest of the great ma- 
jority, I humbly suggest that the administration will have the kind- 
ness to resume the old practical system. 

THE KOKUAS, OR ASSISTANTS, WHO ACCOMPANY 
THE LEPERS TO THE SETTLEMENT 

On this important subject, distinction has to be made between 
married and unmarried kokuas. I think it is but justice, and in 
accordance with Divine and humane law, that faithful husbands 



222 THE PATH OF THE DESTROYER 

and wives of lepers should be allowed to accompany their partners 
to their exile at Kalawao. 

In the fulfillment of my duties as priest, being in daily con- 
tact with the distressed people, I have seen and closely observed 
the bad effect of forcible separation of the married companions. 
It gives them an oppression of mind which, in many instances, is 
more unbearable than the pains and agonies of the disease itself. 
This uneasiness of the mind is, in course of time, partly forgotten 
by those unfortunates only who throw themselves into a reckless 
and immoral habit of living. Whereas, if married men or women 
arrive here in company with their lawful mates they accept at once 
their fate with resignation, and very soon make themselves at 
home in their exile. Not only is the contented mind of the leper 
secured by the company of his wife, but the enjoyment of good 
nursing and assistance, much needed in this protracted and loathe- 
some disease, and which no other person could be expected to im- 
part. 

I am happy to be able to state that the marriage ties of lepers 
have been more respected by His Majesty's Government during 
the past few years than they used to be ; the physical and moral 
life at the Settlement has greatly improved, and the lepers are much 
better taken care of. Besides this, our good kokuas are not only of 
great help and assistance to individual lepers, but they are also 
of great value to the local administration for carrying on all work 
needed for the welfare of the place. May I bring to the notice of 
the honorable members of the Board of Health that not only is our 
Settlement benefited by such kokuas, but the public at large are 
rid of a dangerous element ; and I must assert that it is my solid 
opinion that all persons, with a very few exceptions, who have co- 
habited in the matrimonial state a certain length of time with a 
leper are a standing menace to society at large, of which only too 
many proofs have unhappily come under my personal observation. 
I here leave the medical profession to settle to what extent the 
danger of contagion or non-contagion through cohabitation may 
extend. 

I am happy to give the present Board of Health credit for their 
lenient action in this important matter, at the same time I am 
obliged to mention that I disapprove the coming of all others but 
married kokuas to the Settlement, with the intention of making it 
their place of abode. My disapproval of seeing unmarried kokuas 
settle here is based on the following reasons: 



THE PATH OF THE DESTROYER 223 

1. Because, with the exception of a few old people, un- 
married kokuas are not generally faithful and persevering in assist- 
ing those patients in whose favor they were permitted to come here. 

2. They are, in general, a source of immorality and a tempta- 
tion to lead the lepers into bad habits, and, through their bad 
example, sometimes create trouble in the place. 

3. Because, having no natural tie here, they, after a long inti- 
macy with the lepers, may leave the place whenever they choose, and 
although the disease may not yet be visible, it is highly probable 
that they carry the germs of it to their homes, and thus become a 
well-fitted medium to spread the disease amongst their numerous 
friends. 

4. They are of very little use here, if of any at all. They 
will not do anything for the poor sufferers except for payment, 
with the proceeds of which they go gambling and generally go 
around from house to house and help to consume the poor lepers' 
scanty rations; they have no fixed abode, and are too lazy to work 
for their own support ; in some instances they even try to obtain 
the lepers' clothing by some means or other. 

For these serious reasons I venture to recommend to the 
authorities that they be more strict in the future than they have 
been in the past years; and, to prevent imposition, let proof be 
shown of legal marriage before a permit is granted. Moreover, 
temporary visits which may be allowed to elderly people should 
be always of the shortest possible period, and the strictest severity 
should be resorted to in order to prevent any healthy child or 
young person from entering the Settlement. 

THE MORALITY OF THE LEPER SETTLEMENT 

I feel myself obliged to beg leave of Your Excellency to be 
allowed to speak of a very serious matter, in which I officially 
appear as one of the principal agents. To avoid criticism I will, 
with a liberal mind, lay aside as much as possible all difference of 
creed and opinion, and show how needful a step has been taken for 
the temporal and eternal welfare of our lepers by drawing a 
parallel between the past and the present, and between those who 
yield and do not yield to moral training. 

Previous to my arrival here it was acknowledged and spoken 
of in the public papers as well as in private letters, that the great- 
est want of the lepers at Kalawao then, was not having a spiritual 
leader or priest, the consequence of which was that vice, as a general 



THE PATH OF THE DESTROYER 225 

rule, existed instead of virtue, and degradation of the lowest 
type went ahead as a leader of the community. On the arrival of 
a new number of lepers, the old ones were soon at work to impress 
them with the erroneous axiom: "Aole kanawai ma keia wahi," 
in this place there is no law. Not only in private conversation, 
but in public meetings, I myself heard this doctrine proclaimed ; 
and for a long time, indeed, I was obliged to fight against its appli- 
cation being made to the Divine law as well as to human law. 
In consequence of this impious theory, the people, mostly all un- 
married, or separated on account of the disease, were living pro- 
miscuously without distinction of sex, and many an unfortunate 
woman had to become a prostitute to obtain friends who would 
take care of her, and the children, when well and strong, were 
used as servants. When once the disease prostrated them, such 
women and children were cast out, and had to find some other 
shelter; sometimes they were laid behind a stone wall and left 
there to die, and at other times a hired hand would carry them 
to the hospital. The so-much-praised "aloha" of the natives w T as 
entirely lacking here, at least in this respect. 

As already mentioned in other pages, the Hawaiian "hula'' 
was organized after the pagan fashion, under the protection of 
the old diety Laka, who had his numerous altars and sacrifices, 
and I candidly confess that I had hard work to annihilate Laka's 
religion and worship, and thereby put a stop to the hula and its 
bad consequences. Though the people had reached the climax of 
despair, both of soul and body, may it be said to their honor that 
I found them less addicted to sorcery and the doings of the 
"kahuna Lapaaus," or native doctors, than I had found the old 
natives in Hawaii — circumstances which encouraged me much 
to stay permanently amongst them, with the quasi certain hope of 
my ultimate success as a Catholic priest. 

By a short digression I will speak of another source of im- 
morality, viz. : the evil effects of intoxication. I first have to 
explain how they obtained the material. There grows very abun- 
dantly along the foot of the mountains a plant which the natives 
call "ki" (Dracaena terminalis), the root of which, when cooked, 
fermented, and distilled, gives a highly intoxicating liquid. The 
process of distilling being very crude and imperfect, produces, natu- 
rally enough, a liquor which is totally unfit for drinking. A 
short time after my arrivel the distilling of this horrible liquid 
was carried on to a great extent. Those natives w T ho fell under 
the influence of it w^ould forget all decency, and run about in a 



226 THE PATH OF THE DESTROYER 

nude condition, acting as if they were totally mad. The conse- 
quences can be easier imagined than written on paper. The local 
authorities have endeavored to stop all those horrible proceedings, 
but for a long time they were unsuccessful. It being discovered 
that certain members of our police were in league with the evil- 
doers, the "luna nui" and myself went around and both by threats 
and persuasion, they finally delivered up their implements which 
were used for distilling; some of the most guilty perpetrators were 
convicted, but were pardoned under the condition never to do it 
again. (See page 238, the dissolute element abuse Damien.) 

For a long time, as above stated, under the influence of this 
pernicious liquor, they would neglect everything else except, the 
hula, prostitution, and drinking. As they had no spiritual ad- 
viser they would hasten along the road to complete ruin. A good 
many of the sick and prostrated were left dying there to take care 
of themselves, and several of them died for want of assistance, 
whilst those who should have given a helping hand were going 
around seeking enjoyment of the most pernicious and immoral 
kind. 

As there were so many dying people, my priestly duty to- 
wards them often gave me the opportunity to visit them at their 
domiciles, and although my exhortations were especially addressed 
to the prostrated, often they would fall upon the ears of public 
sinners, who, little by little, became conscious of the consequences 
of their wrecked lives, and began to reform, and thus with the 
hope in a merciful Savior, gave up their bad habits. 

Kindness to all, charity to the needy, a sympathizing hand 
to the sufferers and the dying, in conjunction with a solid re- 
ligious instruction to my listeners, have been my constant means 
to introduce moral habits among the lepers. One of the great 
moral improvements which helped to do away with licentiousness 
was the granting of inter-marriage licenses between lepers who 
were not prevented from marriage by a previous marriage tie, 
and many a couple are today living at the Settlement in a decent 
manner. 

I am happy to say that, assisted by the local administration, 
my labors here, which seemed to be almost in vain at the begin- 
ning, have, thanks to a kind Providence, been greatly crowned 
with success, as, at present, there are very little, if any at all, of 
the above mentioned evils committed. 



THE PATH OF THE DESTROYER 227 

MEDICAL TREATMENT 

Leprosy, from time immemorial up to the present, has always 
been recognized as an incurable disease. In laying my views be- 
fore Your Excellency, with regard to medicine, I must, draw dis- 
tinction between a developed and an incipient case. In regard to 
the first, a judicious medical treatment may be followed up with 
advantage, to ameliorate the condition of a leper, to alleviate his 
pains, and to stay somewhat the progress of the disease; but not 
with the view of obtaining a perfect cure, for such a blessed effect 
we must look for, and can only hope, in a supernatural gift. 

Perchance, in the near future, through the increasing interest 
and untiring perseverance in the study of the disease by the most 
intelligent physicians and scientists, a proper specific for the cure 
of leprosy may be discovered, which to my knowledge has not yet 
been found. 

In regard to an incipent case, where the disease is not yet de- 
veloped, there, in my opinion, with proper medicine, good diet, 
cleanliness, complete separation from all leprous persons, and other 
necessary means, taken with perseverance, there only the hope to 
eradicate the disease from the system, or at least its progress en- 
tirely checked, may be entertained. It is now about twenty years 
since this Settlement was established, and this term may be divided 
in three separate periods. 

As I arrived here at the end of the first period, 1866 to 1873, 
I can only state how I found things at that time. I remember 
well that the poor people were without any medicines, with the 
exception of a few physics and their own native medicines, from 
which, I judge, it had been the same from the inauguration of 
the Settlement. It was a common sight to see people going around 
with fearful ulcers, which for the want of a few rags, or a piece 
of lint and a little salve, were left exposed to dirt, flies, and ver- 
min. Not only their sores were neglected, but anyone getting a 
fever, diarrhoea or any other of the numerous ailments that lepers 
are so often heir to, was carried off for want of some simple 
medicine. 

In the same year of my arrival at the settlement, 1873, there 
arrived a white man, a leper himself, who had been an assistant 
to the doctors at the Kalihi hospital. He had quite a practical 
knowledge of simple medicine, and having been put in charge of 
our hospital, he especially attended to the patients there, while I, 
for my part, attended largely to those living outside. Our stock 



228 THE PATH OF THE DESTROYER 

of medicine, the greatest part of which was always supplied by the 
Board, consisted of the most common necessities. Very soon, the 
people perceiving that by the use of such simple medicines as we 
had to dispose of their troubles were generally greatly ameliorated, 
and therefore they begun to call more and more for the simple 
remedies, and thus gradually a perceptible improvement took place. 
As we had no doctor during this second period, we tried to do the 
best we could. 

To His Excellency Walter M. Gibson, 

President of the Board of Health. 

Dear Sir: I herewith enclose the report of my observations 
and action at the Leper Settlement during a residence of thirteen 
years, which Your Excellency requested me to prepare. Hoping 
that it will meet your views, 

I remain Your Excellency's most humble servant, 

J. DAMIEN, Catholic Priest. 
Kalauwao, March 11, 1886. 



FATHER DAMIEN-PRIEST, LEPER, 
POPULAR HERO 

Joseph Damien de Veuster, otherwise popularly known as 
Fr. Damien, was born at Tremeloo, a small village near Louvain, 
Belgium, on January 3, 1840, and died at Kalawao, Molokai, April 
15, 1889, of nodular leprosy, aged forty-nine years, three months, 
and twelve days. 

His parents were in humble circumstance, his father owning a 
small farm, less than ten acres. His studies for the priesthood 
were pursued at the University of Louvain, and afterwards at Paris. 

He arrived at Honolulu on March 19, 1864. Previous to his 
taking up his residence at the Leper Settlement, he had charge of 
the work of the Catholic Mission at Kohala, island of Hawaii, 
and the Puna district. 

ARRIVES AT KALAWAO 

On Saturday, May 10, 1873, Bishop Maigret, head of the 
Catholic Mission in the Hawaiian Islands, and Fr. Damien landed 
at Kalaupapa, Molokai, from the steamer "Kilauea." 

The Bishop returned to Honolulu on the same steamer, after 
addressing the assembled lepers and informing them, that Fr. 
Damien would remain and make his home with them and devote 
his life to their spiritual welfare and care. 

The Leper Settlement had been in active operation since 
January, 1866; the lepers, for a period of more than seven years, 
being without any resident priest. In the year 1872, Brother Ber- 
tram had built a church at Kalawao, which was dedicated on May 
30th of the same year to St. Philomena by Fr. Raymond Delalande. 

The Protestant church at Kalawao, "Siloam," was erected in 
the year 1870, and was in charge of a native Hawaiian pastor. 

PHYSICAL APPEARANCE 

Fr. Damien was in the thirty-fourth year of his age when he 
began his w T ork amongst the lepers. When I went to reside at the 
Leper Settlement, in the fall of the year 1884, Damien was then 
in his forty-fifth year. He was active and vigorous, of good 
physique, upright in his carriage, measured 5 feet and 8 inches 
in height, weighed 204 pounds, his chest was 41 inches in circum- 
ference, his hands and feet were shapely, although his fingers were 
stubbed and calloused from toil. 




FATHER DAMIEN, 



A. D. 1873. 
In His Thirty-fourth Year. 



THE PATH OF THE DESTROYER 231 

His features were regular, his face fleshy, round, and of good 
dimensions; the color of his eyes brown, his hair black and abun- 
dant; his forehead of average breadth and height. He had a clear 
ringing voice, possessed a powerful barytone, and was a good singer. 

The view of his full face gave the onlooker the idea of force, 
harshness and sternness, due in part to the squareness of his chin 
and lower jaw. His profile was handsome, was softer and more in 
harmony with the entire cast of his features than the view his full 
face presented. Very few of the photographs of Fr. Damien do 
justice to him; his face as sculptured on the monument at Kalau- 
papa bears but an imperfect and faint resemblance to his features. 

Having a wealth of hair, he roamed about bareheaded, result- 
ing in his face becoming bronzed by exposure to the wind and sun's 
rays. 

The first meeting I had with Fr. Damien the dark copper 
color of the skin of his forehead attracted my attention, it was the 
visible proof of the invasion of the Destroyer. 

TEMPERAMENT 

His temperament was mixed, nervo-bilious, the former element 
predominating; he was easily excited, easily peeved, supersensitive, 
and difficult to get along with at times. Damien and I clashed and 
snapped repeatedly. His years of residence at the Settlement had 
made him an autocrat on all matters; he had very fixed views and 
brooked no interference with his will. His unyielding attitude on 
many affairs outside his proper sphere of work brought him in 
conflict with the Board of Health and the workers connected with 
the other religious sects at the Settlement. 

Kalawao had its loafers, illicit distillers, gamblers, thieves, 
card players, card sharpers, ladies of easy virtue. On all these 
classes Damien waged continued warfare, they demoralized his 
flock and led them astray. Very naturally the debauched and dis- 
solute objected to be interfered with, and when attacked turned their 
guns on the attacker. Damien was a good fighter, like all Bel- 
gians, and held his ground ; sometimes the combat was equal, some- 
times unequal and Damien had to retreat, he bided his time and 
returned to attack as defiant and undaunted as ever. 

When the dissolute and debauched element got the worst of 
the battle they craftily begged for forgiveness, assumed an air of 
repentance and reform, and bided their time, which came when 
Damien absented himself from the Settlement to attend to his 
parishioners' spiritual welfare on Kona side of Molokai. 



232 THE PATH OF THE DESTROYER 

THE ENTIRE ISLAND OF MOLOKAI HIS PARISH 

The whole of the island of Molokai was included in his 
sphere of work, and not alone the Leper Settlement. 

The Catholic Mission was shorthanded for years and could 
not spare another priest for the district of Molokai, outside the 
Leper Settlement; hence the work devolved on Fr. Damien, and 
he put as much energy and zeal into his work there as he did at 
the Leper Settlement. He succeeded in erecting several churches 
on the leeward side of Molokai, doing most of the carpentering 
and painting with his own hands. He also found time to visit the 
remote and semi-inaccessible valleys of Wailau and Pelekunu, and 
minister to the spiritual wants of the people there. 

In his report to the Board of Health in the year 1886 ; Fr. 
Damien relates the conditions in existence at the Leper Settlement 
at the time of his arrival in the year 1873. (Page 211.) 

DAMIEN'S LEPROSY NOT CONTRACTED ON THE , 
ISLAND OF HAWAII 

It has been stated, and the story is still existent, that Damien 
had contracted leprosy on the island of Hawaii before he went co 
the Settlement, and his going there was a necessity, not choice. 
Not a particle of reliable evidence has been or can be produced 
to support this contention. 

I visited Kohala, Hawaii, (Damien's field of work prior to 
his leaving for Molokai) in June 1889, and made special inquiries 
on this point as to whether Damien showed any signs of leprosy; 
those questioned had heard some vague story bearing out the state- 
ment, but definite and reliable evidence was not forthcoming, the 
general opinion was, "that no visible signs of leprosy existed on 
Damien's person when he took his departure for Molokai." 

During the years 1888-89 I resided at Hilo, the headquarters 
of the Catholic Mission on the island of Hawaii, and while there 
I acted as physician to Fr. Charles Pouzot, the venerable head 
priest of the mission, where he had worked and toiled for nearly 
fifty years. Questioning all the members of the mission on this same 
subject of "Fr. Damien being affected with leprosy," no evidence 
could be produced to support any such contention. 

HIS ONLY SHELTER— A PUHALA TREE 

Fr. Damien having no home or accommodation when he 
landed at Kalaupapa, took up his abode under the branches of a 



1 




HALA TREE. 

Similar in appearance and size to the tree at Kalawao under which Fr 
Damien slept when he arrived at Kalawao, 1873. Puhala and Lauhala 
are names also used to describe this tree. 



234 THE PATH OF THE DESTROYER 

Puhala tree (Screw Pine or Pandanus) at Kalawao, contiguous to 
the site of the present church, no other shelter being available, ex- 
cept an empty room in a house occupied by lepers, which did not 
appeal to him. Now, had Damien maintained the same attitude 
towards contact with leprosy throughout his period of residence at 
Kalawao as he did on his arrival (when he declined to live in a 
room where lepers lived), the history of Damien, "the martyr 
priest of Molokai," would in all probability never have been 
written. 

NIGHTS OF BLEAKNESS AND DISCOMFORT 

The Puhala tree generally and by preference selects rocky, 
ground to germinate, its aerial roots and their surroundings afford 
a choice nidus for centipedes, scorpions, ants, mosquitoes, roaches; 
and fleas carried by mangy cats, dogs, and sheep, who seek shelter 
from sun, wind, and rain under its branches. 

As if all this is not enough, sleep at night is also interrupted by 
tree rats and noisy chattering birds, such as the mynah and sparrow, 
and roosting poultry. 

I once was compelled to spend the night under the spreading 
branches of a Puhala in the district of Puna, Hawaii, whilst I did 
not have all the vermin companions I have enumerated, I had some 
of them and hereafter would always advise any traveler or way- 
farer not to camp under a Puhala tree. 

Yet, under all the discomforts I have mentioned, Fr. Damien 
began and carried on his work at the Leper Settlement. 

COMPARISONS OF "CONTAGION EXPOSURE" 

Twenty-five years ago amongst the Hawaiian race the average 
duration of a case of nodular or tubercular leprosy was eight or 
ten years, and of the neural form ten to twelve years. 

Amongst the foreign lepers, nodular leprosy ran a more pro- 
longed course, with a minimum duration of ten years. 

The visible active stage of Fr. Damien's leprosy began towards 
the end of the year 1884; he died of the disease April 15, 1889, 
the apparent duration being only four and a half years. 

The true duration of his disease was between ten and eleven 
years, for during the summer of the year 1878, whilst acting as 
assistant superintendent of the Settlement, true prodromal symp- 
toms of leprosy manifested themselves, to wit, chills, osteal pains 
slight swelling and tenderness of the joints, slight irregular fever, 



THE PATH OF THE DESTROYER 235 

tingling, numbness of the extremities, supersensitive and painful 
sensation in patches along the extensor surface of the upper and 
lower extremities; all of which signs, even in the absence of skin 
lesions, clearly indicated primary infection of Damien's system with 
leprosy. After about five years of intimate contact with lepers 
(from the year 1873 to year 1878), he suffered the before men- 
tioned symptoms. 

AN UNCHARITABLE ASPERSION 

In a previous chapter on the subject of "Inoculation," I have 
stated that a widespread opinion exists, even in lay and professional 
minds, that leprosy is spread by inoculation, and solely by that 
means. This unproven and untenable assumption has caused the 
greatest anguish of mind to many unfortunate lepers of our race. 
They are unjustly accused of having acquired leprosy through 
clandestine sexual intercourse with some female leper, without a 
particle of proof that leprosy can be so acquired. 

Even in this twentieth century in Hawaii, I regret to write, 
the Ghost of Immorality stalks abroad, haunts the footsteps of the 
unfortunate leper, and if he is sensitive and refined, adds untold 
misery to his hard lot. 

In previous pages I have patiently endeavored to enlighten 
the advocates of inoculation and teach them that "penile inocu- 
lation by chancre or otherwise, is not responsible for the spread of 
leprosy from INDIVIDUAL to INDIVIDUAL, but that CON- 
TAMINATED food is, also contact with the leper's mouth, un- 
less the CONTACT (male) or CONTACTEE (female) is 
IMMUNE by reason of NON-RECEPTIVITY of the SYS- 
TEM, or CAREFUL CLEANLINESS. 

I have reason to believe that the unfortunate Damien was 
spared the torment and distress of even suspecting that his infec- 
tion with leprosy would be attributed to immorality. Be this as 
it may, when it first become publicly known that Fr. Damien had 
leprosy, some such accusation of his acquiring the disease by im- 
moral acts must have leaked out. The matter was abruptly brought 
to my notice in the early part of the year 1885 by a certain prom- 
inent physician who visited the Leper Settlement at that time. 

On or about May 7, 1885, this certain physician stated to 
me whilst we were eating breakfast: "Dr. Mouritz, Fr. Damien 
will come to the dispensary at Kalawao at 10 o'clock, I want you 
to be there, we can then see how his leprosy is progressing. I 



236 THE PATH OF THE DESTROYER 

also wish to specially examine him for evidence of other diseases. 
We will make a thorough examination." I assented. 

In due course and at the appointed time Fr. Damien arrived, 
serene and undisturbed. When asked to disrobe, he readily con- 
sented; we found sufficient proof that he was undoubtedly a leper, 
but nothing more. 

We searched his mouth, throat, and cervical glands, also care- 
fully scrutinized his entire person and found absolutely NO 
TRACE of any other disease. This event happened nearly 
thirty years ago, but the details are fresh in my memory; strange 
to say the "victim" of our examination did not display any re- 
sentment, and did not seem to realize the important bearing the 
discovery of any incriminating evidence might have on his future. 

Fr. Damien possibly realized that the syphilis-leprosy theory 
which was then hypnotizing a certain portion of the popular mind, 
might be invoked in connection with his acquiring leprosy, he well 
knowing that syphilis can be inoculated innocently and accidentally, 
no question of morality intruding itself in such a case. 

The contact of Damien with leprosy was always careless and 
reckless during the few years I was connected with the Settle- 
ment. I never hesitated to scold him and lecture him, because it 
set a bad example to other non-lepers. 

PROLONGED AND INTIMATE CONTACTS 

Mother Superior Marianne, and some of the Sisters have had 
prolonged and intimate contact with leprosy, both at Kakaako and 
Molokai, for a period over thirty-two years, and they are free from 
leprosy. "The Immunity of Cleanliness" is their guardian and 
protector. 

Mr. Joseph Dutton has had the same class of contact as the 
Sisters for nearly thirty years, night and day contact, week in and 
week out, year in and year out, but I never knew or heard of 
the Sisters, the Rev. Mother, or Mr. Dutton eating from the same 
dish with other lepers. 

From the date of Fr. Damien's arrival, May 10, 1873, to the 
time of his death, April 15, 1889, is a few weeks less than sixteen 
years (some twenty-five days less). 

Mother Superior Marianne and some of the Sisters spent five 
years at Kakaako detention hospital, and have passed over twenty- 
seven years at the Bishop Home, Kalaupapa; in all a total of 
over thirty-two years, almost double the contact and exposure that 



THE PATH OF THE DESTROYER 237 

Fr. Damien was subjected to, but the venerable Mother and Sis- 
ters are free from leprosy. The same statement applies to Mr. 
Joseph Dutton, who has lived continuously at Kalawao since July, 
1886, nearly thirty years, under conditions of prolonged and inti- 
mate contact with leprosy — he is also free from the disease. 

The late Fr. Wendelin lived nearly fourteen years at Kalau- 
papa, exposed to the same risks of contagion as Fr. Damien, but 
up to the time of his death in Honolulu, September 1, 1914, he 
showed no signs of leprosy. 

Fr. Wendelin took only the ordinary precautions that any 
prudent man would to avoid leprous infection; on the other hand, 
Fr. Damien took no precautions whatever. In the kindness of his 
nature, he never forbade lepers entering his house, they had access 
to it any time, night or day. I named his house "Kalawao Family 
Hotel and Lepers' Rest," free beds, free board for the needy; this 
designation I believe could not be improved on, it exactly fitted 
the daily prevailing conditions. In marked contrast was the atti- 
tude of Frs. Albert and Wendelin towards lepers who came to see 
them and ask for aid, neither of these priests admitted lepers to 
their private apartments, visiting lepers were received on the lanai 
or in their studies, the leper visitor stated his business briefly and 
departed. 

A MODEST REPORT 

In his report to the president of the Board of Health in 
March, 1886, Fr. Damien gives only a modest and limited in- 
sight into his self-chosen, dangerous, and arduous work amongst the 
lepers; what he does not mention are the following vital facts: 

His house stood in close proximity and to the LEE side of the 
burial ground connected with his church, in this said burial ground 
over 1,000 leper corpses were buried. Owing to the rocky nature 
of the ground in some places, the corpses were not regularly dis- 
tributed, in places two, three, and four coffins were placed on top 
of each other, naturally the soil became over saturated with the 
soluble products of the corpses, and the percolating rain drowned 
the maggots and other grubs; hence decomposition went on very 
slowly, the surrounding air being filled with foetid and foul va- 
pors emanating from these semi-decomposing corpses, and to add to 
the gruesomeness of the surroundings, the closeness of the coffins 
to the surface of the ground encouraged the visits of scavenger 
dogs and pigs, and by these animals rooting and disturbing the 
graves, the odor around Fr. Damien's home was similar to a 



238 THE PATH OF THE DESTROYER 

charnel house; but such vital conditions essential to good health as 
pure air, did not worry the priest. 

Forty years ago leprosy in Hawaii, in its advanced stages, 
was very much more severe and loathsome than it is today; also 
when the leper arrived at the Settlement his disease was of many 
years' duration, his tenure of life was very brief; hence there was 
a high annual mortality. In the seventies the smallness of the 
leper houses and absence of ventilation made the foetid breaths, the 
smell from the foul ulcers of the dying and semi-putrid cadavers 
so nauseating that it sickened the strongest stomach. Here worked 
Damien night and day, living and sleeping in this polluted, foetid 
atmosphere; cheerful, careless, and care-free. In addition, his food 
cooked and handled by a leper; his clothes washed by a leper, even 
his pipe smoked by a leper when he (Damien) carelessly laid it 
aside — not once but often — and so surrounded by a multitudinous 
aggregation of disease-producing conditions "that his escape from 
leprous infection would have been marvelous, and even miraculous." 

The resulting climax came about; Fr. Damien succumbed, fell 
a victim to the dread "Incurable Destroyer," and passed on to his 
reward. His own view on becoming a leper was, "If Providence 
sees fit to afflict me with the leprosy whilst I am working amongst 
the lepers, I will gain a Crown of Thorns, whether I am worthy 
or not." 

The brief period of five months elapsed between the arrival 
of Fr. Wendelin coming to aid Damien and the latter's death. Fr. 
Wendelin arrived in November, 1888, Damien died in April, 1889 

OPPOSITION TO DAMIEN 

Several writers who have given to the world what purports 
to be a history of the life of Fr. Damien, have commented on 
the fact that hostile opinions were held about the priest in the 
village of Kalawao, the scene of his earthly labors. This is noth- 
ing remarkable; quite a minority of the residents were opposed to 
the ways and the work of the priest. This opposition and non- 
appreciation of the man came in the main from two sources : 

A. The non-members of the Catholic Church; this opposition 
was not personal, it was in fact only friendly rivalry. 

B. The dissolute and debauched Hawaiians and a few for- 
eigners. This opposition to Damien was personal, and highly 
slanderous. 

(a) Fr. Damien was a most zealous, untiring worker on be- 
half of the Catholic Mission, and everything pertaining to the 




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240 THE PATH OF THE DESTROYER 

welfare of his flock, and his policy, fulfilled in every sense, and was 
an exponent of the short, pithy expression, "The end to be obtained 
justifies the means or method used." He was always planning and 
devising schemes to extend the power and membership of his 
church. Beginning with a slim church attendance and scant funds, 
Damien worked quietly and persistently until the Catholics had a 
membership of two-thirds of the lepers, and in worldly riches they 
had double the property of either the Protestants or the Mormons. 

On another page I have stated the pastor of the Protestant 
Church at Kalawao was a native Hawaiian, Rev. J. Hanaloa, aged, 
semi-blind, and burdened with a leper wife. The average native 
Hawaiian pastor, with a FEW exceptions, has not the training, 
ability, or energy to compete with a foreign priest or pastor of 
any denomination. 

As assistant pastor, where a Hawaiian is braced up, he makes 
good; but others who have full charge of a parish are not always 
competent to fill that position. This statement should be taken 
as no unkind reflection on the Hawaiian minister; the material 
from which a stable and efficient ministry can be built up is not 
obtainable in a few decades of civilization. 

The Catholic Church, in its wisdom, has never invested with 
ministerial functions any native Hawaiian to my knowledge. The 
Romish Church has always moved with the greatest circumspec- 
tion in this matter. 

Fr. Damien's active and persistent energy assumed a propa- 
ganda of proselytism, his church was filled to overflowing, whilst 
the other churches were scantily attended. 

If the members of Fr. Damien's church failed to attend Sun- 
day services, bright and early Monday morning Damien visited the 
home of the non-attendant to know the reason, illness alone was 
accepted as a legitimate excuse. 

The native Hawaiian pastor of the Protestant Church, and 
also the Mormon elder, failed to pursue the same course which 
Damien did; hence their flocks diminished or remained stationary. 

Again, the Catholics owned numbers of houses built by their 
own funds or willed to the church by deceased lepers. The ac- 
commodations in these houses were better than those provided by 
the Board of Health, inasmuch as they were not overcrowded, they 
were much sought after, especially by lepers with families, and 
also by new arrivals. 

If the occupants of these Catholic houses failed to live up to 
the standard of a good Catholic, Damien bounced them out when 



THE PATH OF THE DESTROYER 241 

they failed to heed his repeated warnings; these ejected parties had 
to seek other quarters, they became enemies of Damien and joined 
the ranks of the opposition and waged a secret verbal war against 
the militant priest. 

(b) Some pages back I mentioned that Damien fought the 
makers of distilled liquor, the drunkards, card players, gamblers — 
in short, the dissolute and debauched element. Quite naturally, they 
fought back, aided and abetted by some of the foreign lepers; but 
they signally failed to defeat Damien. They spread around stories 
abusing him and accusing him of lax relations with certain women, 
but their statements were too absurd, scandalous, and malicious 
to carry any conviction of their TRUTH. (See page 226, attacks 
the "hula" and raids on liquor makers.) 

When the unfortunate priest fell a victim to leprosy the ele- 
ment hostile to him in the Settlement pointed to this fact as cor- 
roborative of the truth of the charges they had made, but they 
overlooked one particularly significant condition, which was this, 
The very women whom Damien s name was connected with, were 
some of the cleanest in the Leper Reservation; they were kokuas 
or helpers, were non-lepers, never became lepers — / know from 
personal observation they were not affected with leprosy at the 
time of their death. 

During the time I was connected with the Leper Settlement, 
I had free access to Fr. Damien's rooms at all hours, both night 
and day — on the priest's premises there were no locked doors or 
screened windows. 

In the year 1878 Damien acted as assistant to Sumner, who 
then held the office of superintendent of the Settlement, and he 
(Damien) informed me, "that he had, and was glad to, resign 
the office, owing to the fault-finding and the continuous complaints 
made against him." 

All of which goes to prove that no matter how unselfish and 
self-sacrificing the priest may have been, even to losing his own 
life, yet he encountered opposition and made many enemies. 

Fr. Damien's intense zeal, unflagging energy carried him over 
many difficulties, but a long residence at the Leper Settlement had 
tended to make him overbearing, dictatorial, autocratic; he brooked 
no interference in his own affairs, but was continually interfering 
in matters that did not concern him. His frequent intrusion upon 
the duties of R. W. Meyer, manager of the Settlement, caused dis- 
putes, hence strained relation existed between them at frequent in- 
tervals. 



242 THE PATH OF THE DESTROY ER 

As for myself, I often had to tell the priest in no uncertain 
tone and language, "I want no advice nor interference; mind 
your own business, attend to your own proper sphere of work, to 
wit, the spiritual welfare of the lepers; do not listen to the tittle- 
tattle and inane gossip of the Settlement." 

* * * 

THE AVERAGE THINKING MAN will be safe in con- 
cluding, when he looks back and contemplates the fading track of 
past years, that since Fr. Damien's departure HENCE, from 
the scenes of his earthly labors, he surfers no discomforts, neither 
sorrow nor pain; because the former things have passed away. 

If we are to believe that charity and kindness cover a multi- 
tude of sins, and also the doctrine of "Justification by our Works,'' 
who is prepared to deny that sixteen years of privation, hardship, 
and disagreeable work, nights of watching and answering calls to 
the sick and dying at all hours, vigils and many weary hours passed 
in the night and darkness by the bleak and inhospitable shore at 
Kalaupapa, awaiting the homeless leper and ORPHAN — all this 
work must surely count, and it is amply sufficient to win salvation 
for Damien. 

PASSING PLEASURES 

Leprosy and the Leper Settlement had not always a gloomy 
side, at times jokes and good humor abounded. The laughter- 
loving, light-hearted and pleasure-seeking Hawaiian is not easily 
moved to despair of the future ; hope that the morrow will be no 
worse than today is every present. 

Fr. Damien at times joined in frolics with the "kids," skip 
the rope, tag me not, hide and go seek, "buff" the blind man, etc., 
were all entered into with childish glee. 

The days of his boyhood, and the nature of the work he had 
been engaged in in his youthful days showed itself, and came to 
the front in his delight watching the taming of unruly cows and 
unbroken colts. Poultry raising was also one of his great relax- 
ations, he had a great number of hens and chickens and abundance 
of eggs, which were always at the disposal of the sick, whether 
they were Catholics or not. 

The late Charles Warren Stoddard in his little book, "The 
Lepers of Molokai," describes the scene: "The priest, calling his 
chickens to be fed, hens and chickens flew from all quarters of the 
Heavens, alighting on Damien's head and shoulders or anywhere 



THE PATH OF THE DESTROYER 243 

they could obtain a foothold, fighting and struggling to reach the 
dish (which held the food) in his hands." This scene occurred 
in the month of October, 1884, when Stoddard and I visited Fr. 
Damien. 

Damien enjoyed a joke, was quick at repartee, and was fond 
of teasing. He once came upon me when I was walking in his 
churchyard at Kalawao, he asked my business. I answered : "The 
filling of the coffins with quicklime would be as efficient as cre- 
mation." Damien remarked: "It would be a good thing, but are 
not doctors quite proficient in filling coffins, without quicklime?" 
I laughed at this sally, bided my time ; it came a few days later. 
Damien made the statement, "the Sisters, if some could be spared 
from Kakaako, would greatly aid the lepers.'' I assented, but in- 
sisted that the time was inopportune, that he (Damien) would 
speedily become too exalted and proud ; quite naturally, he resented 
the remark and asked me to explain. I answered, "whenever a Sister 
or nun comes you (Damien) will have no equal." He then asked 
me "why not?" and I replied, "when the nun arrives, Fr. Damien. 
you will have no equal, because you will be second to NONE. 
He was slow to see this jeu de mots, but when he did perceive it, 
it made him shake with laughter. 

One subject, it appeared to me, Damien was always pleased 
to discuss. He was imbued with certain lofty ideas and believed 
in the possibility of their future realization — the Leper Settlement 
to be a special diocese, Damien to be vicar-apostolic, with special 
powers direct from the Pope, and the work of the whole Settle- 
ment to be carried on under strict ecclesiastical lines, like a mon- 
astery. R. W. Meyer took delight in teasing Damien on the 
possibilities of this scheme panning out, and would often say, 
"Father, how soon shall we see you with shaven poll and tonsure, 
assuming this will mark your new order." Damien would laugh 
heartily and refuse to be drawn out. 

One other matter, and I will finish this chapter. I have 
never seen any other priest, doctor, or other contact, assume the 
same careless and indifferent attitude towards infection with leprosy 
as Fr. Damien did, save and except Dr. Fitch. 

If Fr. Damien was uncleanly, it was often from necessity, 
not choice, for how can a man wash his hands before eating when 
there is no water to wash with? Even during my stay at the 
Settlement, water was a scarce commodity, and for days and days 
the pipes contained no water. This was to be expected with a 
reservoir head of sixty feet and only a one-inch and a three-quarter- 

l 



244 THE PATH OF THE DESTROY ER 

inch pipe for main delivery, extending a mile and one-half, up and 
down, over small hills, with broken couplings, leaky pipes and num- 
erous faucets. No spare fittings were kept in stock, extra couplings, 
T's, elbows, reducers, and faucets were conspicuous by their absence. 
Fr. Damien was a jack-of-all-trades, but carpenter work was 
his mania and recreation. He did good work, his good physical 
development enabled him to work for hours with little fatigue. 
Bath tubs, window and door casings were his specialty, and were 
at the disposal of all. 

THE PROGRESS OF DAMIEN'S LEPROSY 

Whilst the incipient symptoms of Fr. Damien's leprosy were 
plainly visible in the year 1884, the disease made slow progress, 
and followed the usual course that hundreds of other cases have 
done at the Leper Settlement. 

About the month of October, 1885, his disease began to take 
on renewed activity, and the typical manifestations of leprosy be- 
came very prominent. Nodular deposits in the right ear became 
extensive, the cheeks, lips, forehead, and chin showed marked in- 
filtration, and rapid alopecia of the eyebrows and other hairy parts 
became very pronounced. About the month of March, 1886, I 
wrote to Bishop Herman, head of the Catholic Mission, on the 
desirability of Fr. Damien proceeding to Honolulu and taking the 
Goto treatment of hot baths and other medicines, which was then 
in vogue, very popular with the lepers, and said to cure the disease. 

The Dr. Goto treatment is carried on in Japan and is of 
long standing; it gives relief to certain symptoms of leprosy, fails 
to effect a cure, is very expensive to carry out in Hawaii, Dr. Goto 
having a monopoly of the drugs used. In many cases where the 
heart, lungs, spleen, and kidneys are much implicated, its effects 
are positively harmful; great loss of weight and emaciation occur, 
the patient presents a semi-asphyxiated appearance, marked lividity 
of the skin and mucous membranes taking place, indicating des- 
truction and elimination of the haemoglobin of the red blood 
corpuscles, and puckering and crenation of these bodies ; under these 
conditions asphyxia livida is produced, due to excess and defective 
elimination of the carbon dioxide in the blood. 

Some of the lepers expressed themselves as deriving great 
benefit from Dr. Goto's treatment. No doubt in properly selected 
cases hot bathing is beneficial, but hot. baths three times a day for 
an hour or more, exhaust the strength of the average leper. Se- 




FR. DAMIEN, A. D. 1887. 
In the grasp of the DESTROYER — two years previous to his death. 



246 THE PATH OF THE DESTROY ER 

lection of proper cases for any routine treatment is the office and 
work of the trained physician ; haphazard and indiscriminate se- 
lection must end in disaster and failure, no matter what treatment 
is pursued. The same suit of clothes will not fit everyone, nor is 
the same suit, of clothes suitable for meeting the changing condi- 
tions of the weather every day of the year. 

In due course Bishop Herman answered my letter, wrote to 
Fr. Damien to come to Honolulu, all arrangements being made for 
his sojourn at Kakaako hospital. Fr. Damien went to Honolulu,, 
but within two weeks returned to the Leper Settlement, stating. 
he felt homesick for Kalawao, had to remain idle in Kakaako ; but 
meanwhile he had learnt all about the carrying out of Dr. Goto's 
treatment, would establish his own bathhouse at Kalawao and an- 
other for the boys and girls at his home. He did nothing, however, 
until almost the end of the year 1886. Meanwhile every mail 
brought him alleged cures for leprosy from all over the world, to- 
what extent he used the multitude of medicines sent him I do not 
know. If he did use them it made no difference in the progress of 
his leprosy, which rapidly advanced, and with remarkable severity.. 
At the beginning of the year 1887 the skin of the abdomen, chest,, 
and back, both extensor and flexor surfaces of the arms and legs 
showed tubercles, masses of infiltration, deep maculation in varying 
degrees of extent and severity. The mucous membrane of the nose, 
palate, roof of the mouth, pharynx and larynx became involved ;- 
the skin of his cheeks, nose, lips, forehead, and chin became ex- 
cessively swollen, deep copper-colored macules and deep infiltra- 
tion alternately prevailing; his body became emaciated. 

Early in the year 1887 Fr. Damien was able to get the much- 
talked-of Goto bathing and medicines established at Kalawao. 
He proceded immediately to demonstrate his belief in the treatment 
by excessive use of both medicines and bathing, using hot water at 
a temperature of 108°, and remaining in the same for hours; drink- 
ing a tea of the nature of a semi-bitter tonic, Aesculus Turbinata, is 
part of the treatment, and also a handfull of herbs is used in- 
the bath, supposed to dissolve in the water and liberate medicinal 
properties, together with all this, a teaspoonful of pills weighing- 
about 2 grs. each, is also partaken of daily. After a few weeks 
of vigorous use of this Goto treatment, it had the effect that I 
have already stated, giving Fr. Damien a semi-asphyxiated appear- 
ance, symptoms of aphonia and dyspnoea showed up ; he tottered 
in his walk, his clothes appeared like bags hung on his figure, the 



THE PATH OF THE DESTROYER 247 

? 
lobes of both ears became enormously enlarged, reaching to his 

collar. Bronchial catarrh, oedema of the feet completed the train 

of grave symptoms; yet, in the face of this evidence of the un- 

suitability of the Goto treatment for his case he claimed it was 

doing him good, and he felt better than he had been for the past 

two years. He lost at least thirty-five pounds in bodily weight 

at this time. About the month of June, 1887, many of the lepers 

began to drop off the Goto treatment, this also influenced Fr. 

Damien, and he dropped the hot bath part of the treatment to 

one bath every other day, but the mischief had been done, and his 

system refused to respond and he grew weaker. 

THE BENDING OF THE OAK 

In September, 1887. it. became apparent that Fr. Damien had 
given up all hope of getting any relief or stay of his leprosy, his 
weakness became apparent to himself; the slightest exertion brought 
on difficulty of breathing; his temper, which previously had been 
alternately cheerful and irritable, became preternaturally calm, and 
permanent gloom settled down upon him. 

His face, although dreadfully and distressingly disfigured by 
masses of leproma and general leprous infiltration, showed unmis- 
takable signs of grief and anguish, (this despair and anguish a 
condition of mind quite common amongst the victims of leprosy) 
came upon the suffering priest at recurrent intervals in two forms: 

First. — "Melancholia Attonita," where he remained motionless 
and silent, with his eyes looking fixedly into space. 

Second. — "Melancholia Religiosa,'' strange to say, occasionally 
troubled him — THE DELUSION OF HIS BEING UN- 
WORTHY OF HEAVEN. This was most remarkable, for if 
there was any man in the universe who had every prospect of 
future happiness and salvation, that man was Damien. 

One constant worry was ever present also in the mind of the 
dying priest; it was this: "Who will look after my poor orphan 
boys and girls when I am gone?" 

The question has often been asked and variously answered, 
"why was not another priest sent to help and relieve Damien of 
his work?" The answer is, "even if a priest had been sent to his 
assistance, Damien would not have relinquished his work; he 
preferred to struggle on to the end and die working in harness." 

He stuck to his work and he even appeared to me to work 
harder as his strength gradually became sapped by the disease. I 



THE PATH OF THE DESTROYER 249 

departed from the Leper Settlement in the month of January, 1888. 
Damien's death was then plainly in sight. His stomach had be- 
come gravely involved ; he suffered constant gnawing pain, con- 
tinuous sensation of hunger, nausea, heartburn, vomiting, syncopal 
attacks and great depression. Added to other troubles, the leper 
is affected with a voracious appetite, which causes him to overtax 
his stomach; this condition is due in part to fibroid changes in the 
walls of the stomach, atrophy of the circular muscular fibres of the 
pylorus, together with dilatation ; the stomach bolts and rapidly 
ejects its contents, almost as soon as the food enters, hence the 
leper feels constant gnawing pains and hunger. 

Fr. Damien lived some fifteen months after I left the Settle- 
ment. He had resided in Hawaii a few weeks over twenty-five 
years. He passed away about 8 a. m. on April 15, 1889; this was 
the Monday before Easter — he had earnestly prayed for death at 
this season, hoping to greet his "MASTER" on Easter Morn. 



The Catholic Church did not entirely monopolize Fr. Damien 
or his work amongst the lepers, Protestant and Catholic alike aided 
him, religious prejudices and jealousies rarely appeared; if they 
did, they were speedily forgotten and relegated to the background. 

In the year 1886 a clergyman of the Church of England, Rev. 
Chapman, of Camberwell, London, collected $5,000 from amongst 
his parishoners and friends. This money was placed in the hands 
of Fr. Damien without any restrictions whatever and to be put 
to whatever use the priest saw fit. This gift of £1,000 was a 
handsome token of friendship and good-will from the English 
Protestants to Fr. Damien. 

Fort Street Church, Honolulu, known as the Missionary 
Children's, through its members, generously aided Fr. Damien in 
his work on Molokai. The donations furnished were quietly and 
unobtrusively given to aid Fr. Damien directly and indirectly and 
all the lepers. 

The missionary children and their descendants were the richest 
members of the church, and they devoted their wealth to a good 
cause; helping, elevating, and comforting the last hours of the un- 
fortunate outcast lepers on Molokai, until the Grim Reaper came 
upon the scene. 

FATHER ALBERT MONTITON 

The work of the Catholic Mission at Kalaupapa was in charge 



250 THE PATH OF THE DESTROYER 

of Father Albert, he was Father Damien's assistant and fellow 
worker amongst the lepers, and had resided at the Settlement for 
several years, from September 8, 1882, to March 31, 1885, when 
he left Molokai to take up other work. 

Father Albert was French, and at this time, when I first met 
him, was nearly sixty years of age. He was diminutive in stature, 
of slender physique and poorly nourished, due to a life of priva- 
tion, really starvation, amongst the inhabitants of the Paumotu 
Group of Islands, near Tahiti in the South Pacific. Here he 
resided for nearly twenty years. 

The people of these islands were unfriendly to strangers, and 
cannibalism was practiced amongst them. When they were not 
feasting on human flesh ; their daily means of subsistence was raw 
fish and cocoanut, a food utterly unsuitable for a Caucasian. 

The effect of the unhealthy climate, impure water and poor 
food, caused Father Albert to suffer from stomach trouble, dysen- 
tery, and a severe skin disease — Inveterate Psoriasis, Diffusa and 
Gyrata (Lichen Ruber Planus in appearance) ; these bodily ail- 
ments caused him to leave the scene of his labors to se^k medical 
treatment in Tahiti. 

With very little relief, after months of treatment, he returned 
to his cannibal parishoners, labored patiently for some more years 
longer, until extreme illness caused him to abandon his labors. 

Father Albert left Tahiti for Valparaiso, Chile, where no 
treatment benefited his skin trouble. Finally he went to Europe 
and when he reached Rome, the Pope gave him audience. 

Father Albert was placed in the care of the best physician of 
the Vatican, who treated him for months with little or no benefit- 
Trie Pope then sent him to the famous skin specialist of Vienna,. 
Austria, Dr. Ferdinand von Hebra, who, after months of treat- 
ment, decided his disease was incurable (probably a form of lep- 
rosy), and advised Father Albert to seek a warm climate. Finally, 
Father Albert reached Honolulu, and was sent to Molokai, where- 
the climate, and a better quality of food than he had been able to> 
procure in the Paumotus, materially improved his psoriasis. 

Father Albert's appearance when he first went to Molokai 
gave the impression that he was a leper; scaly hands, face, and 
alopecia of the hairy surfaces of the body, also chin, cheeks, and 
eyebrows. In the month of March, 1884, Dr. Ed. Arning visited 
Kalaupapa with Princess Liliuokalani (her report is on page 295 
of this book). The doctor saw Father Albert (who had now 
given up all hope of relief from his skin affection), and in. 



THE PATH OF THE DESTROYER 25 i 

duced him to persevere in the use of the remedies he prescribed;, 
heroic doses of arsenate of soda, and externally, salicylate of bis- 
muth ointment. Under this treatment the psoriasis yielded, and 
after several months Father Albert's skin assumed its natural state,, 
and he was practically cured of a disease of twenty-five years' 
existence. 

Father Albert though sixty years of age was quite active, and 
easily took care of the needs and welfare of the lepers living at Ka- 
laupapa and Iliopi. These villages were very sparsely settled, the 
bulk of the lepers residing at Kalawao. 

Frequently he repeated to me his desire to spend the rest of 
his life at Kalaupapa, because he enjoyed good health and was free: 
from the misery of his companion psoriasis, which possibly might 
return if he changed his residence. Something, however, came into 
his life and altered all his previous hopes of permanent residence 
at the Settlement. He informed me one day in March, 1885, he 
was leaving the Settlement for other spheres of labor, his disease 
had left him, and he felt with renewed vigor he could undertake 
other duties; that Fr. Damien was still hearty and strong and 
could amply cover the field of work of the Leper Settlement. 

Fr. Albert had no signs of leprosy during his residence at 
Kalaupapa, and left the Settlement free from any taint of that 
disease. He died in Spain in the year 1894. 



FATHER GREGOIRE ARCHAMBAUX 

Father Gregory, a priest of the Catholic Mission, who had 
lived many years in the Hawaiian Islands, arrived at Kalawao 
near the end of the year 1887, and resided with Father Damien for 
about four months. 

The Father had undergone all the hardships of poor food, 
and hard work, being located at Hana, Maui, a damp, rainy dis- 
trict, and latterly at Lahaina, Maui. In his time the numerous 
steep and rocky trails which ran through the various large gulches 
made traveling arduous and dangerous, especially in the periods of 
heavy, rains and freshets in the rivers, which had to be forded on 
horseback, no bridges spanning the streams. 

Dr. Beratz, a very able and accomplished Austrian physician, 
was drowned in the year 1871, in one of these streams when in 
flood. The rainfall in the mountains of the Hana district is very- 
heavy, as much as 300 inches per annum in the Keanae Valley. 



252 THE PATH OF THE DESTROYER 

Amongst these inhospitable surroundings in a sparsely popu- 
lated district, Father Gregory passed many years of his life, sleep- 
ing anywhere, wherever he happened to be at nightfall — in caves, 
grass houses, and other homes of the Hawaiians, any place that 
he could obtain food and shelter. 

In these situations he encountered typhoid, small-pox and 
many cases of leprosy. He slept repeatedly in rooms with lepers, 
and had to EAT the food of the family, which practically means 
contaminated with bacillus leprae. 

Father Gregory was affected with incipient NODULAR 
LEPROSY. He was French, nearly six feet tall, of powerful 
build, complexion dark and swarthy, he had abundance of black, 
wavy hair, and a remarkable thick and long growth of eyebrows, 
which his leprosy had not yet begun to diminish. He had been 
pronounced a leper by a board of examining physicians, and came 
to the Leper Settlement with the object of remaining there per- 
manently and aiding Father Damien. 

Besides leprosy, Father Gregory suffered severely from asthma, 
and posterior spinal sclerosis, taking the form of "Lightning Shocks/' 
affecting the muscles of the lower extremities, which at times 
brought the Father to his knees involuntarily, and sometimes with 
ludicrous explosions from the onlookers. 

His leprosy gave him very little inconvenience, but the copper- 
colored macules and infiltrations caused him visually great an- 
noyance, hence he vigorously applied sublimate of mercury in 
strong lotions — 60 grs. to a pint of Eau de Cologne — in hopes of 
eradicating the aforementioned skin troubles, but he only succeeded 
in creating centers of traumatic eczema, which, when healed, left 
the skin more red and copper colored than it had been before 
the sublimate lotion was used. 

Both the macules and the small, slightly elevated areas of 
infiltration were devoid of sensibility and failed to sweat; these 
two conditions being almost pathognomonic of leprosy. Mercurials 
and iodides produced no effect, so there was no question of the 
nature of his disease, because syphilis is the main cause of loco- 
motor ataxia or posterior spinal sclerosis, and has symptoms re- 
sembling leprosy and may even be present complicating this disease. 

During the few months Father Gregory stayed at Kalawao, 
his asthma was much aggravated, and his appetite and strength be- 
gan to fail rapidly, and I suggested a return to Kakaako. Father 
Damien also thought it best, because Father Gregory was unable 
to perform any service, and was an added burden to him (Damien). 



THE PATH OF THE DESTROYER 253 

Father Gregory was only too pleased to return to Honolulu; 
the Board of Health raised no objections, and shortly after the 
Father left Kalawao for Kakaako, where his asthma and nervous 
disease became gradually worse, and he died there Nov. 12 in the 
year 1888. 

He had often been connected with the Leper Settlement, act- 
ing as temporary priest for many years. 

* * * 

FATHER CHARLES POUZOT 

Father Charles, the venerable priest in charge of the Catholic 
Mission work at Hilo, Hawaii, was well on to seventy years of 
age when I became his medical attendant in the year 1888. He 
had ministered to the spiritual wants of his parishoners in the 
Hilo district for well nigh forty years. 

North of the Wailuku River, which runs through the town 
of Hilo and empties itself into Hilo Bay, the climate is rainy, 
almost resembling the Hana district, where Father Gregory was 
located. South of the Wailuku River, the climate is less rainy. 
Hilo town has a rainfall of about 15 inches a month. 

Father Charles, like most Catholic priests in the country dis- 
tricts fifty years ago, led a hard life, visiting the sick and- dying 
at all hours, irregular meals and poor food were his lot; rain- 
bound, he frequently had to eat and sleep with Hawaiians, who 
are always hospitable and at times too kind for their own good. 

Father Charles had stomach trouble and suffered repeated 
attacks of acute indigestion, with lurking appendicitis, but I dis- 
covered a more interesting condition in the course of a clinical 
examination, to wit: specific neuritis affecting the nerves of the left 
forearm and hand, due to leprosy, which was quiescent and had 
aborted, but it had left marked atrophic changes in the muscles, 
the typical hollow between the thumb and forefinger was there, 
defective sensibility of the hand and skin of the forearm; there 
were also atrophic changes in certain areas of the body, higher in 
color than the neighboring skin, and insensitive; thermo-anaesthesia 
and symetrical enlargement, or bulbing of the ulnar nerve above 
and below the elbow joint completed the picture. As usual, the 
atrophic invasion of neural leprosy had confined itself to its favor- 
ite seats, the interossei, thenars and extensors of the hand. 

Father Charles, unlike Father Gregory had never visited or 
had any connection with the Leper Settlement. The acquiring of 
leprosy by these two priests tends to show that a healthy person 



254 THE PATH OF THE DESTROYER 

is exposed to contagious foci of leprosy outside of Molokai, and 
inasmuch as the cases of leprosy are lurking, or may or may not be 
detected, there is a certain element of greater risk, because the 
danger is unexpected and a person is caught off his guard. 



FATHER ANDRE BURGERMANN 

Father Andre, who spent many years at Lahaina, Maui, and 
.also had charge of leeward Molokai, and paid transient visits to the 
Leper Settlement, was another priest who had symptoms of leprous 
neuritis, almost identical with those of Father Charles Pouzot. 

In addition, Father Andre had ataxic symptoms, and the 
"Lightning Shocks," similar to Father Gregory, together with in- 
coordination, disturbances of sensation, and loss of reflexes. He 
was well on to sixty years of age when I observed his condition 
in the year 1894. 

The suspicious changes in his left hand were caused by neural 
leprosy, which had aborted, as it very frequently does in this 
location. 

Father Andre did have intimate contact with leprosy at the 
Leper * Settlement, and lived at Kalaupapa from July, 1878, to 
July, 1880. 

The acquiring of leprosy by these four Catholic priests, Andre, 
Charles, Damien, and Gregory, all Europeans, is fairly conclusive 
that leprosy is contagious, that it spreads fro?n individual to in- 
dividual, and a de novo development cannot be maintained. 

IN MEMORIAM 

FR. WENDELIN 

"Now I lay me down to sleep, 
I pray the Lord my soul to keep." 

Entered into rest at the Catholic Mission premises, Fort 
street, Honolulu, Father Wendelin Moellers. 

He fought the good fight, and passed away on September 1, 
1914. 

He was born on March 21, 1850, near Miinster, Westphalia, 
Prussia, and was the youngest of six children. At the time of 
his death he was in the sixty-fifth year of his age. He studied for 
the priesthood at the University of Louvain, Belgium, and was 




o 

M-l 

o 

2 : 

< .s 

< "2 
W 5 



256 THE PATH OF THE DESTROYER 

ordained priest in the year 1878. His first sphere of work was 
at Tahiti and the Marquesas Islands, where he labored for seven 
years. He came to the Hawaiian Islands in the year 1885, and 
was placed in charge of the district of Koolau, Oahu. 

HE GOES TO DAMIEN'S AID 

Owing to the rapidly failing health of Father Damien at 
the Leper Settlement, Father Wendelin was sent to his relief in 
the month of November, 1888, and he remained at the Settlement 
until October 9, 1902, nearly fourteen years; during all these 
years he labored nobly and did excellent work, the mantle of 
Father Damien falling on Wendelin's shoulders after Damien's 
decease, at. whose obsequies he officiated. 

During Father Wendelin's term of office and under his splen- 
did administrative ability, the churches, the schools, the Baldwin 
and Bishop Homes reached a high degree of spiritual efficiency, also 
the general religious work of the Settlement went on apace; all 
of which progress would have delighted the heart of Father 
Damien, had he then been living. 

In Father Wendelin's period of residence at Kalaupapa, 
marked changes and improvements took place. The lepers had 
better housing, and their material comfort was vastly improved, an 
abundant supply of water was brought into the Settlement from 
Waikolu Valley, the conditions of sea transport were much changed 
for the better. 

Special personal work of Father Wendelin was the building 
of St. Francis Church at Kalaupapa, a large and handsome build- 
ing destroyed by fire on August 12, 1906. 

DOES NOT CONTRACT LEPROSY 

Father Wendelin was eminently just and upright, plain spoken 
almost to bluntness, no taint of scandal ever tarnished his name, 
he was most abstemious in his habits and endured the life of pri- 
vation and toil that falls to the lot of most Catholic priests. He 
was exposed to the same risks of contact with leprosy as Father 
Damien, but the FELL DESTROYER never infected him. Father 
Wendelin spent fourteen years at Kalaupapa in intimate contact 
with leprosy, ' and after leaving that land of SORROW he lived 
twelve years longer, but never a trace of the disease showed itself. 

In appearance he was slim of build, stood about five feet 
six inches tall, had a very small head, his gestures, walk and speech 




'RAPID FIRE" WENDELIN, COOLING OFF. 
A. D. 1910. Sixty years old. 



258 THE PATH OF THE DESTROYER 

were rapid and full of action — he was playfully called "Rapid 
Fire" Wendelin — his temperament was of the typically nervous 
type. He weighed about 140 pounds. 

GIFT FROM THE LEPERS 

When Father Wendelin took leave of his leper parishoners, 
they performed a most pathetic and touching deed. The poor and 
needy lepers with stinting and saving, raised enough money to pro- 
cure from Paris a gold chalice of exquisite workmanship, which 
they presented to the departing priest as a token of their love and 
esteem. The subscribers were not confined to the members of the 
Catholic Church, the other churches also contributed. 

The last twelve years of Father Wendelin's life were spent 
at Lahaina, Hilo, and Honolulu from February, 1909, to the time 
of his death. 

To me personally this Catholic priest was especially attrac- 
tive. He was an able debater, his arguments were clear and in- 
cisive, if they were not absolutely convincing; it was impossible to 
cut them down clear to the base, there remained a snag or stump 
that was impregnable. Prussia, of course, is the dominant state 
of the German confederation, and the peculiar racial traits of the 
Prussian showed themselves in Father Wendelin, and explains his 
clash with the Board of Health. 

He possessed a charming freedom of speech and expression, 
remarkably rare in a Catholic priest. He spoke and wrote what 
he thought was right, and signed his name, no beating and stabbing 
behind the back; deceit, guile, and chicanery found no dwelling 
place within him. In these modern days of insipid mediocrity, de- 
bates and discussions with Father Wendelin were highly illumina- 
tive and entertaining. 

OVERWORK CAUSES BREAKDOWN 

He did not spare himself, with the never failing result — his 
health gave way — hurried and scanty meals, irregular and inter- 
rupted hours of sleep began to tell their tale, stomach trouble 
showed itself, then heart starvation, next irritable heart and 
tachycardia, next organic heart disease, muscular degeneration, and 
finally came dilatation of the left ventricle with thinning of its 
walls ; all these changes occurred slowly ; later shortness of breath, 
♦hen the decision, "I must see a doctor," but it was too late. 
Father Wendelin had reached sixty-three years of age, and rebelled 




FR. WENDELIN AND HIS CLASS. 
A. D. 1910. 



260 J HE PATH OF THE DESTROYER 

against his physician's orders to rest; hence the mischief done to 
his heart could not be stayed or repaired. 

THE SWEEP OF THE REAPER 

During the summer of the year 1913, the cardiac symptoms 
began to trouble him, shortness of breath on very slight exertion 
and excessive heart's action, all these symptoms gradually increas- 
ing until March, 1914, when other grave symptoms occurred — 
anginal attacks, lung engorgement, and temporary thrombosis of 
the pulmonary artery. During the last few days of April, all the 
indications pointed to his speedy death, but under the skilful treat- 
ment of his physician, Dr. St. D. G. Walters, he improved, finally 
taking to his bed May 1, 1914. June, July, August passed, 
Father Wendelin's death being expected on five different occasions, 
so alarming and continuous were the anginal attacks. After three 
days passed in a semi-comatose condition, the end came on Sep- 
tember 1, 1914, and he passed quietly away to his reward. 

Dr. Goldsmith's lines, written in the year 1770, are a fitting 
tribute to Father Wendelin's life: 

"To relieve the wretched was his pride, 
In his duty prompt at every call, 
He watched and wept, he prayed and felt for all. 

Beside the bed where parting life was laid, 
And sorrow, guilt, and pain; by turns dismayed, 

The Reverend Champion stood. At his control 
Despair and anguish fled the struggling soul; 
Comfort came down the trembling sinner to raise, 
And his last faltering accents whispered, praise. 
At Church * * * 

Truth from his lips prevailed with double sway, 
And fools, who came to scoff, remained to pray. 

His people's welfare pleased him and their cares distressed; 
To them his heart, his love, his griefs were given, 
But All his serious thoughts had rest in Heaven. 
As some tall CLIFF, that lifts its noble form, 
Swells from the vale, and midway leaves the storm, 
Though round its breast the rolling clouds are spread, 
ETERNAL sunshine settles on its head." 



THE PATH OF THE DESTROYER 261 

In the year 1888, Bishop Herman desiring to send another 
priest to aid Fr. Damien, addressed a circular letter to all the 
eligible priests of the Mission, asking them if they were willing 
to go to the Leper Settlement. 

Some of the priests gave favorable answers, some pleaded un- 
fitness, some made no reply. Fr. Wendelin gave his answer in a 
few words: "My answer is our rules,'' which was tantamount to 
stating, "I obey my Bishop, and will go where he orders me to go." 
Fr. Wendelin was chosen. 

During the last year of Fr. Damien's life a strange event took 
place; the coming to the Leper Settlement of Fr. L. Conrardy 
from Oregon. He came at the special instigation of Fr. Damien, 
who acted against the wish of Bishop Herman ; the affair was very 
displeasing to the bishop and the priests of the Mission. Fr. 
Damien was stubborn, self-willed and refused to listen to any 
remonstrance; he determined to have his own way and acted 
accordingly. 

Fr. Conrardy was of a different order of priests from those 
of the Catholic Mission in Hawaii. He remained seven years at 
the Settlement, and later he labored amongst the Chinese lepers 
near Canton. He died at Hong Kong, August 24, 1914. 

The Conrardy affair might have developed into a very un- 
pleasant situation, but it was smoothed over and mollified by the 
tact and diplomatic finesse of Fr. Wendelin. 



THIRTY-ONE YEARS AN OFFICIAL OF 
THE LEPER SETTLEMENT 

I have previously related that one R. W. Meyer held the 
position of agent of the Board of Health and superintendent of 
the Leper Settlement. He resided at Kalae, a locality immediately 
above the steep sides of the Kalaupapa pali, which, at the trail of 
Kukuihapuu, reaches an elevation of 2,200 feet above the sea, 
which ebbs and flows directly at the base of this mountain. 

The late Charles Warren Stoddard in that, entertaining and 
pathetic little book, "The Lepers of Molokai," admirably des- 
cribes the difficulties of ascent and descent of the palis adjacent to 
the Leper Settlement; the angles of elevation in various parts of 
the old trails, such as Stoddard described in the year 1884, vary 
from 30° to 90°, the average angle of ascent is steep, about 40°. 

Meyer had a long record of service, holding the position of 
superintendent of the Settlement from its inception in the year 
1866 to 1897, when he deceased. He had resided on the island of 
Molokai some forty-seven years, coming to Hawaii from Australia, 
to which country he had emigrated from his birthplace, Ham- 
burg, Germany. He was well educated and wrote and spoke 
fluent English, came from a good family, had the average German 
characteristics — stolid, level-headed, a clever thinker, and a stickler 
for obedience to his will and discipline. 

Meyer had an estimable Hawaiian wife, Kalama. His atti- 
tude towards the Hawaiians and treatment of them, whether they 
were lepers or not, always gave me and many others the impression 
that he was a little harsh and severe in his dealings with them ; 
he judged them by a too high standard. Living on an isolated 
island like Molokai, Meyer's continual association with inferiors, 
mentally and socially, made him very arbitrary. 

During Meyer's tenure of office the clandestine travel up and 
down the Kukuihapuu trail was kept to a minimum, permits to 
visit the Leper Settlement were held up if they showed the slight- 
est informality; a hawk's eye was kept on all the traffic passing by 
his gate, which was located on the road to the Settlement; all this 
very much conduced to efficient segregation. 

For the several years I was connected with the Leper Settle- 
ment, there was one everlasting growl and complaint about its 
management, and the source of trouble was centered on Meyer, 
but in justice to the man, I must add most of the growls, kicks 
and fault-findings were unjust and frivolous. To give satisfaction, 



THE PATH OF THE DESTROYER 263 

to please and placate the numerous and varied collection of lepers, 
the holder of the office of superintendent would require to be of 
the type of the Archangel Gabriel, and even then dissatisfaction 
would exist. I know all this from personal experience. 

Sick people, the world over, are fault-finding, complaining, 
fretful, irritable and discontented. Those who are in constant con- 
tact with the sick, expect to meet with all this trouble, and the 
Leper Settlement furnished a full quota of chronic growlers from 
amongst the various races in segregation. 

R. W. Meyer paid quarterly visits to the Settlement, spending 
a few days there, a period of time, the lepers decided, was much too 
brief to be of any real service to them; an absentee official was not 
to their liking. 

Meyer mostly depended on the reports and the conditions out- 
lined therein, furnished by the deputy superintendent. When com- 
plaints were made to him (Meyer) personally, by the lepers about 
poor quality of food and its insufficiency, leaky houses, poor qual- 
ity of the blankets and clothing supplied from the local store, 
shortage and irregluar distribution of oil, soap, and matches, and a 
multitudinous variety of other complaints, Meyer returned an in- 
variable grim stereotyped answer. "You are well treated; compare 
your present condition and circumstances with what you had to 
put up with before you came here. Here you have nothing to do, 
have beef, poi, rice, salmon, hard bread, sugar, all supplied in 
liberal quantities. What more do you want? Your complaints 
are most unreasonable and unnecessary." The growlers would 
ease off for a little time, and then begin anew with renewed ardor. 

All physicians connected with the Leper Settlement prior to my 
taking office, were invariably unjustly criticised and subjected to 
unkind and sarcastic comments by Meyer, whose dislike of doctors 
was considerably augmented by the severe criticism on the manage- 
ment of the Leper Settlement made by Dr. J. H. Stallard, of 
date March 13, 1884, in a special report to the late A. S. Cleg- 
horn, then a member of the Board of Health. 

A. S. Cleghorn, husband of Princess Likelike, sent Dr. Stal- 
lard to the Leper Settlement to investigate the truth and circum- 
stances calling for the continual complaints coming from the lepers, 
concerning "shortage of their rations, suffering from cold due to 
insufficient personal and bed clothing," and many other troubles. 

Dr. Stallard in his report criticised, strongly arraigned and 
severely censured the management of the Settlement, which stung 
Meyer, and he answered Stallard in kind. The shortage of beef 



264 THE PATH OF THE DESTROYER 

and other food shown up by Stallard was only too true, and 
Meyer's answer failed to change the merit and justice of the com- 
plaints of the lepers. (Dr. Stallard's report will be found in another 
part, of this work.) 

The continual complaints and troubles connected with the 
unsatisfactory management of the Leper Settlement ultimately 
reached a climax. 

In the month of February, 1886, I was ordered to report at 
Honolulu at my earliest convenience, and when I did so, I was 
urgently requested to take over the entire management of the 
Settlement. 

I promptly declined the office, having troubles enough as the 
physician of the Settlement. I did not care to butt into a hornet's 
nest and take further responsibility. In those days of political 
bitterness and factional strife, holding government office was no 
sinecure. 

The next year, in June, 1887, there came a change in the gov- 
ernment and its officers, due to a bloodless revolution. 

Later on when a new Board of Health assumed office (and 
manifesting real or apparent hostility towards me), it, gave me a 
sufficient loophole to resign my position as physician to the Leper 
Settlement and the island of Molokai, an office I had never sought, 
and reluctantly accepted; but I gained experience in leprosy, which 
repaid me for many discomforts and troubles. 



REPORT OF R. W. MEYER 

Superintendent and Agent of the Board of Health at the Leper 
Settlement, Molokai, April, 1886. 

REMARKS BY THE SECRETARY OF THE BOARD OF 

HEALTH 

The accompanying report of Mr. Meyer, agent of the Board 
of Health at the Leper Settlement, in reference to the Settlement, 
is very interesting, in so far as it gives a somewhat connected view 
of the condition of things at the Settlement since its establishment, 
by one who was connected with it from its inception; but as Mr. 
Meyer has not. been an actual resident, but has lived some ten 
miles distant, and only paid occasional visits to it, say once in three 
months, he has not had the fullest opportunity to observe the 
condition of affairs, or to aid in carrying out every reformation 
that has or might have been carried out, or of accurately noting the 
various changes that have been made. Therefore, Mr. Meyer has 
not dealt minutely with some of the most interesting events in the 
history of the Settlement at regards the phases of leper life, such 
as the Lepart, Walsh or Ragsdale management, when the last 
named was practically a king among his fellow sufferers, and hold- 
ing in his will the power of life and death ; nor to the labors of 
the resident physicians, from the days of Drs. Emerson, Neilson, 
and Fitch, to those of the present active incumbent, Dr. A. Mouritz. 
Information on these several points will, however, be found more 
fully set forth in other portions of this general report. 

REPORT 

To His Excellency Walter M. Gibson, 
President of the Board of Health. 

Dear Sir: In presenting my report of the Leper Settlement 
for the past two years, I am led to reflect upon the great difference 
existing in the comforts and ease enjoyed by the lepers at the 
Settlement of today, when compared with the first few years of its 
establishment, now just twenty years ago. It may, therefore, not 
be amiss to recite briefly the history of that time, as it shows a 
constant endeavor on the part of the government to improve the 
condition of these unfortunate people, and as I have been connected 
with the affairs of the Settlement ever since the very commencement 
(1865-66), I am in a position to speak from personal knowledge. 



266 THE PATH OF THE DESTROY ER 

Leprosy had already existed on the islands for about twenty 
years before it seriously attracted the attention of the government, 
and even then the nature of this disease was poorly understood, 
and the great magnitude of the calamity was not realized, except- 
ing by a few men of the medical profession, who urged the neces- 
sity of segregation as being the only means known through which 
this terrible disease had been stamped out in other districts, and it 
was justly hoped that segregation here would lead to a similar 
favorable result; and it probably would have done so, had it been 
possible to rigidly enforce the segregation of lepers, even as late 
as the time when the law of segregation was enacted (1865), for 
the known cases of leprosy on the islands at that time were com- 
paratively few. 

The present site of the Settlement, which was established in 
1865, was deemed to be the most suitable spot for the isolation of 
the lepers on the islands, one-half of it being bounded by an almost 
vertical mountain wall, from 1,800 to 2,000 feet high, and the 
other by a deep sea, with a precipitous shore, excepting only in 
two places, one at Kalaupapa, and the other near Kalauwao, where 
in good weather boats can make a landing safely. 

The tract of land constituting the Leper Settlement projects 
from the main body of the island, and forms a kind of shelf, in- 
cluding probably an area of about 5,000 acres, abounding with 
every variety of soil, and everything necessary to supply the wants 
of natives (fruits, taro, potatoes and many other vegetables can 
be grown here to perfection), and leaving a large area of land to 
be utilized for the raising of stock; the sea abounds with fish, and 
before this place was occupied by the lepers, it sustained a very 
large and thriving population. 

Unfortunately the place is not well watered. There is, how- 
ever, on the eastern boundary of the Settlement a considerable and 
never failing mountain stream in the valley of Waikolu, which is 
about a mile, or a trifle more, distant from Kalawao. There are 
other springs in the valley of Kalawao, and one or two in the 
valley of Waihanau, but all at considerable distances from the habi- 
tations. These springs, however, during very dry times are sub- 
ject to suffer diminution of water, and the one at Kalawao at 
such times is liable to dry up. 

It was thought at that time if such a place as above described 
was given to the lepers, where they could live unmolested, they 
might, with the assistance of some of their families, make comfort- 
able homes for themselves, without incurring much greater ex- 



THE PATH OF THE DESTROYER 267 

penses to the government than the cost of collecting them together, 
giving them an outfit of clothing, a few other necessaries, and the 
transport to the Settlement. And such of these unfortunates who 
were known to be possessed of means, and who had not managed 
to place them in the hands of friends, in such a way that they 
could not be got at, had to pay them over to the government as a 
reimbursement for expenses incurred in their behalf. 

The original inhabitants of the place owned a great many 
pieces of land and houses, the houses being mostly thatched ones, 
and only three or four were wooden structures; the lands were 
mostly planted with taro, potatoes, and other vegetables. Most of 
these houses and lands were purchased by the government for the 
accommodation of the lepers, and the planted lands for their 
support. 

All the first shipments of lepers were allowed to take their 
wives and husbands with them, or a son, and in some instances a 
daughter, but children were not permitted to accompany them. 

The Board of Health bought for future use for the Settlement 
some young heifers, a few horses, one or two pairs of oxen, and a 
cart for the use of the lepers, and they were expected to obtain 
their living from the growing crops, to take care and re-plant them 
and live there precisely in the same way as natives do in any 
settlement on the islands. 

Unfortunately, segregations proceed slowly, and six months 
or more had elapsed from the time of the vacation of the place to 
the time of the arrival of the first shipment of lepers, and when 
they arrived they found the cultivated fields overgrown with 
weeds, and they had very hard work to save enough to eat for 
themselves. However, they managed it, commenced to like the 
place, and got along very well until after considerable intervals 
one or two more shipments of lepers arrived. 

No food was given these people excepting what the first com- 
ers were willing to give them, which was not much ; they were 
willing to work for themselves, but not for others, and the first 
trouble arose through it. Fortunately, the place was overrun with 
a native pear, and natives had lived on this fruit previously, and 
these beans supported them till the Board concluded to furnish 
these people with food for a sufficient length of time to enable 
them to raise their own ; but that time, with many, never arrived ; 
finding that they got food any way, they made no efforts to work 
for themselves, and supplies had to be bought. And many really 
could not work, their hands and feet being too sore. It was also 




KING KAMEHAMEHA IV. 

Husband of Queen Emma. 
Founder of the Queen's Hospital, A. D. 1860. 

Born February 9, 1834. Died November 30, 1863. 






THE PATH OF THE DESTROYER 269 

found that they could not obtain sufficient fish or meat for their 
support, and they received from the Board small allowances of salt 
beef or salmon. They were allowed three pounds of meat and 
one bundle of paiai per week, and nothing else. Some became desti- 
tute of clothing, and this was supplied them annually, and only to 
such as had no means or friends. The men received each a pair 
of blankets, a denim frock, a pair of pants, a hat, and some of 
them shoes. The women also a blanket, a shirt of blue or brown 
cotton, and a calico dress; with this they were expected to get 
along for a whole year. 

For a considerable time there was nobody to look out for these 
people, a man was sent there just to receive them, show them the 
houses, and give them their weekly allowances of bread and paiai. 

As already stated, water was scarce, and had to be carried 
considerable distances, and it may be imagined great inconvenience 
and considerable suffering arose from it. 

It was but natural that troubles also arose between them which 
led to quarrels, and, as there was nobody to settle these matters, 
they had to do it themselves the best way they could. Many of 
them were approaching the latter stages of the disease, and those 
who had no friends or relatives with them suffered more or less ; 
but I must say, to the credit of these people, that, as a rule, they 
almost always found a friend in their extremities. There was no 
hospital or building in those days where they could be taken care of. 

It became necessary to appoint a superintendent, and an elderly 
gentleman (Mr. Walsh), with his wife, was sent to the Settle- 
ment to fill this position. This gentleman having been an officer 
in the British army, was accustomed to discipline, and he tried his 
best, and succeeded to a certain extent, to bring some system 
and order in the affairs of the Settlement. A hospital was erected, 
the building still standing, and the worst cases were taken there 
under the immediate care of the superintendent and his wife. Food 
was prepared for them, and they got other things, such as a little 
bread, rice, some tea with sugar, and as by this time the heifers 
had become cows, there was some milk for them also; thus really 
for a time considerable suffering from want of attention was re- 
lieved. Unfortunately, the superintendent and his wife did not 
understand the Hawaiian language, and many of his endeavors to 
establish rule and order were not understood by the people, and 
constantly little troubles arose between him and the people, and 
they became as discontented as ever. The poor man fell sick 
and died, and his widow became superintendent ; as assistant, an 



270 THE PATH OF THE DESTROYER 

old sea captain was sent up, but these two could not agree — neither 
of them could speak with the people, and matters did not. improve; 
and, in addition to these troubles, the lepers did not receive their 
full allowance of meat, which was only three pounds per week. It 
culminated in the discontinuance of the foreign superintendents, 
and natives t or half-castes were tried, and, as experience has proven, 
with the best results. Natives are perfectly willing to submit to 
considerable pressure, even oppression, if it comes from one of their 
own people, but not from a foreigner. 

It was often difficult to supply the Settlement with food, es- 
pecially during the winter season, when the landings are bad; an 
attempt was therefore made to cultivate the valley of Waikolu 
with taro, and manufacture the paiai on the spot. This business 
was undertaken by agents of King Kamehameha V in 1870; the 
valley was leased to them at the regular market price. Agents were 
appointed to prosecute the work, and, I am sorry to relate, that 
some of these agents, in their anxiety to please the King, took 
away from the lepers all the taro patches they had cultivated for 
their own use without the least remuneration. One poor leper 
alone lost twenty patches. Of course, this proceeding put a stop 
to any future cultivation of lands by the lepers and their families. 
Thus matters continued at the Leper Settlement without material 
changes till the death of Kamehameha V (in December, 1872), 
when, with the ascension to the throne by Lunalilo, a new Board 
of Health was appointed. 

Segregation was held by the new Board to be the only means 
of arresting the progress of the disease, and the most energetic 
efforts were made to effect the isolation of lepers, and without 
regard to person. Lepers were no longer allowed to take their 
wives or husbands with them, and visits to the Settlement ceased 
to be permitted, excepting only under the most strenuous circum- 
stances, and only for a brief interview. 

The injustice of claiming the means possessed by lepers was 
at once discontinued ; and in the instances where it had been col- 
lected, mostly from the poor widows, it was refunded to them. 
The wants of the lepers were considered, and their weekly rations 
of meat increased, and they were also allowed a greater variety of 
food, and henceforth received five pounds of meat, or if they 
wished, three pounds of salmon per week; also one bundle of paiai 
containing twenty-one pounds, or, if they wished, either ten pounds 
of rice or seven pounds of bread or flour, and five pounds of salt 
per month. 




QUEEN EMMA. 

Wife of Kamehameha IV. 
Foundress of the Queen's Hospital. 



Born January 2, 1836. Died April 25, 1885. 



272 THE PATH OF THE DESTROYER 

A little labor was considered to be beneficial and even neces- 
sary for the lepers; and, to encourage them to cultivate the lands 
again, they were allowed the choice to receive the cash value of 
their weekly supplies of food in lieu of the food itself. This 
arrangement, subsequent experience has proved to be of great 
benefit to the lepers as well as to the Board. The lepers managed 
to cultivate more food than was necessary for their own use, and 
during winter months, when it was difficult to bring food from 
adjacent valleys, there was a supply at hand which was bought 
from the people at the regular market price; thus many of them 
obtained means to supply wants which were not filled by the 
Board. Some accumulated money enough to build houses and 
surround themselves with other comforts, and all without costing 
the Board one cent more than it would have done otherwise, and 
it was really rather a saving. 

The difficulty of giving the lepers an annual supply of clothing 
caused it to be discontinued, and, instead of it, a store was estab- 
lished containing every variety of staple goods, to be sold at less 
prices, only with sufficient advance to cover the expenses of its 
management and attendance; and such lepers, instead of receiving 
clothing, were given a bill to the amount of six dollars, for which 
they could draw at the store what they wished, and these bills were 
given out just before the commencement of winter on the 1st of 
October. This arrangement has not been unprofitable to the Board, 
and it has been of the greatest comfort to the lepers up to this 
day, and in fact, it would be impossible to do without it. 

The great bulk of food consumed at the Settlement has 
chiefly been purchased from the people living in the adjacent valleys 
of Pelekunu, Wailau, and Halawa, and from there it was mostly 
brought by the planters to the Settlement in their own boats, sub- 
sequently in boats belonging to the Board, and by men hired for 
that purpose. As already has been said, during the winter season 
it is at times impossible for boats to land, and food cannot be 
landed. To meet this difficulty, a stock of provisions — bread, flour, 
and chiefly rice — has to be kept on hand to be used in such emer- 
gencies. 

The valley of Waikolu, which forms a part of the Board of 
Health lands, seemed to offer the means to obviate all the diffi- 
culty, and another attempt was made to cultivate the same. A 
contract was made with the male friends, or relatives of the lepers 
living at the Settlement to cultivate this valley for three years. 
They were to plant, take care, and prepare the taro, and deliver 



THE PATH OF THE DESTROYER 273 

it to the officers of the Board ; and they were to receive as re- 
muneration one-half of its market value. This plan promised to 
work well in the first and part of the second year; but the people 
got tired, and when the three years were up they were unwilling 
to continue the work, and it was given up again. 

Besides lepers there existed, and still exists, a large number 
of people, males and females, who had been allowed to accompany 
the lepers during former years. Most of these, having no other 
homes, found the place a very likely one, where they could make 
an easy living, chiefly obtained from the lepers. To prevent the 
too great increase of these people, as well as to discourage idleness, 
the old time-honored Hawaiian rule of "poalima" (fifth day) was 
established, and which was then in force all over the islands. It 
simply consists in that every able-bodied male has to give one 
day's labor per week to the Board, and in turn they were allowed 
to enjoy the privileges the land affords — precisely the same as the 
lepers, with the exception, however, that they receive no rations 
for either food or clothing. To this rule, being accustomed to it, 
all cheerfully consented, and it has been kept up strictly until re- 
cently, but the rule has not been abolished. 

A limited number of these people called kokuas, or assistants, 
are absolutely necessary to live at the Settlement, for the per- 
formance of the work connected with the slaughtering of animals, 
receiving and distribution of food, preparing food and providing 
fuel, local police, messengers, etc. ; but all those regularly employed 
are exempt from the poalima rule, and, in addition, they receive 
food rations from the Board. 

Hospital accommodations were increased, and bedsteads fur- 
nished to the inmates instead of their being compelled to lie on 
the floor or mats, as heretofore. 

Water pipes were laid on from the spring in the Kalawao 
gulch to the hospital, with intermediate taps for the use of the 
people living all along the road, which relieved them of the great 
burden of going for the water and carrying it considerable dis- 
tances, and they also had more water. 

When His Majesty Kalakaua ascended the throne (in 1873),* 
most of the gentlemen composing the Board of Health under 
Lunalilo, with the exception of the president, remained in office 
for some time, and matters continued to go on very much the 
same way as under Lunalilo. * 1874 — Author. 

The number of lepers at the Settlement had increased by this 
time to about 800, and, in spite of all their efforts to effect their 



274 THE PATH OF THE DESTROY ER 

isolation, numbers always remained behind. Want of sufficient 
means was probably the cause that segregation was enforced only 
spasmodically. 

By this time the biennial Legislature evinced more interest in 
the condition of their unfortunate fellow-men at the Settlement 
than had been the case previously, and at nearly every session a 
committee was appointed to visit the Settlement and report on 
their modes of living, sufficiency of food, houses, etc., of the 
lepers; and, in consequence of one of these visits during the 
Legislature of 1878, of which committee Your Excellency was chair- 
man, the Settlement received the special attention of the Legisla- 
ture, which resulted in an increase of their weekly meat rations 
from five to seven pounds; a number of cottages were also erected, 
and the lepers received additional necessary articles, such as soap 
and kerosene oil, and their allowance of ten pounds of rice was 
change to nine pounds, with one pound of sugar. 

Previous to this, the Settlement had received very little medi- 
cal attention, a physician used to come from Maui, two or three 
times a year, visit the Settlement for a few hours and return. Sub- 
sequently, efforts were made to obtain the services of a resident 
physician, the Legislature having provided an appropriation of 
$10,000 for a physician for the Leper Settlement, which has met 
with varying success. 

By this time, 1886, all the grass houses at the Settlement have 
disappeared and given place to wooden cottages, which are white- 
washed, inside and outside, twice a year, for which purpose, lime 
is furnished the people by the Board free of expense to them. 

There are now, at the present day, according to a recent 
counting, in all 327 buildings at the Leper Settlement, which in- 
cludes all the hospital buildings, dwelling houses, store, store- 
houses, and drug-shop, and five places of worship, of which two 
are Catholic, two Protestant, and one a Mormon church. Of 
these buildings, 109 belong to the Board, partly purchased, little 
by little, from the lepers, but chiefly built on purpose for their 
accommodation. The rest of the houses are owned by lepers, built 
by them at their own expense, and some of them quite handsome 
ones; they number in all 213 houses. 

Most of these houses are of various sizes, and accommodate 
various members, but they have small rooms, probably more than 
three or four times the space allowed under ordinary circum- 
stances; all these houses have windows and doors, and thus, as they 
are but one-story buildings, they have all the necessary ventilation. 



THE PATH OF THE DESTROYER 275 

There are now many more houses than existed eight or ten years 
ago, when the number of lepers reached 800 and upwards, whereas, 
at the present day, there are but 652. From this alone, it follows, 
that they are more comfortable, with regard to lodgings, than 
they have been. 

The Leper Settlement, with all its houses neatly white- 
washed, w T ith its churches and other buildings, its surroundings, 
imposing scenery, certainly presents a very pleasing and cheerful 
appearance, especially on fine days, when the population turns out. 

The lepers are allowed to own horses and they may frequently 
be seen in large numbers all dressed up and enjoying themselves 
at their heart's content, some few also have carriages, and they 
may be seen driving; they have, also, a music band, very creditably 
managed by one of the lepers. Were it not that these unfortu- 
nates carry the evidence of their misfortune in their faces, it would 
be impossible to distinguish this Settlement from any other of the 
same size on these islands. It is probably superior to many. 

For the lepers w T ho reach the advanced stages of the disease, 
as well as for those who have no friends, there are now fine build- 
ings, called hospitals; they are w r ooden structures 46 feet long, by 
20 feet wide, and 9 feet high, and for the better ventilation these 
houses are unceiled and have short chimnies to promote a current 
of air. There are two rows of bedsteads in these houses at a dis- 
tance of about 4 feet between each ; they are whitewashed at least 
twice a year, inside and outside, and are kept as clean as it can 
possibly be expected with the means at hand. There the lepers 
are cared for, their food is prepared for them, they receive tea or 
coffee with sugar or milk, and some extras when the case demands 
it. These hospitals are at Kalauwao, about 2 miles distant from 
the landing at Kalaupapa, and surrounded with a picket fence 
enclosing an area of about one and a half acres. The ground in 
front of the hospital buildings within this enclosure has latterly 
been converted into a garden, where the inmates, or those who take 
an interest in it, plant flowers and some vegetables, making the 
place look cheerful. The hospitals are in charge of a native 
steward, who, I am happy to say, takes considerable pride in doing 
his duty well, and to have all the buildings clean, and the wants 
of the sick attended to. A new cook-house has been built, probably 
eighteen months ago, and whenever I have seen it, it always w T as 
clean and tidy, very different from what it used to be. These 
hospitals are also regularly washed, and there is really now but 
very little bad odor compared with former years, when the means 
of obtaining a sufficiency of water were difficult. The clothing of 
the inmates is washed by people employed for that purpose. But 



276 THE PATH OF THE DESTROY ER 

in spite of the care taken to make these people comfortable, very 
few care to go into the hospitals, they do not seem to feel at 
home there, and the buildings are seldom more than very partially 
filled; at present there are only 43 inmates; 36 of them are males, 
and 7 females. 

Besides these hospitals there are two other buildings, one for 
boys and another for girls, which are in charge of Father Damien, 
and on this account they are in the immediate proximity of his own 
dwelling-house. These houses are intended for the reception of 
orphans or children who have neither parents nor friends at the 
Settlement. 

Other children at the Settlement, live with their parents or 
relatives, in the same manner as they do in other places. There 
are two schools for them, one at Kalaupapa, the other at Kalauwao; 
the former has a kokua, not a leper, for a teacher; the latter a 
leper. The leprous and non-leprous children go into the same 
school, but are kept in separate places in each of these schools. 
The number of scholars in all are 50, of whom 36 are boys and 
14 are girls. 

Segregation of sexes has only been attempted with the hospital 
yard, where the women occupy separate houses from the men ; and 
with the children, living in the two houses in charge of Father 
Damien. 

The condition and behavior of married people at the Settle- 
ment appear to me to compare very favorably with other places, 
and I do not believe that their standard of morality falls below, 
if any, that of people living in other settlements. Everything is 
done to provide for married people either separate houses or rooms, 
as far as the means at hand allow this to be done. 

The lepers do not directly receive clothing from the Board, 
but they receive an order to the value of six dollars annually, for 
which they receive at the store whatever articles they stand in 
need of; but I must say that, as they now have no means of earn- 
ing any money, that those who have no friends to assist them can- 
not clothe themselves sufficiently for six dollars per annum; and 
there would be more or less suffering were it not that charitably 
disposed people, especially the people of Honolulu have occasionally 
sent such contributions of clothing, etc. ; collected by Her Majesty 
the Queen, which supplied the wants of the needy ones. 

Friends and relatives of lepers living on the other islands are 
permitted to visit the Settlement, and live with the lepers for a 
shorter or longer time, from one week to a ?nonth or more, pro- 
vided they produce a permit. (Very lax segregation. — Author.) 

For the preservation of law and order, a magistrate has been 
appointed, who, although vested with the authority of a district 



THE PATH OF THE DESTROYER 277 

judge, uses his office chiefly as a judge of peace, or peace arbi- 
trator. All difficulties and disputes arising between the lepers 
are settled in a friendly manner, without expense to either party, 
and apparently to the satisfaction of all. 

With the exception of the one unfortunate case of man- 
slaughter, committed at the Settlement in November last, crimes 
have been of rare occurrence. Since 1882 there has been but one 
case of burglary, and during the last two years only one case of 
attempted burglary. For such crimes, of course, the offenders are 
punished with imprisonment; but, being sick, the time of imprison- 
ment is made very much shorter than the law really prescribes. 

As laws and rules which cannot be enforced had better not 
be made, it has ever been the endeavor of those having had charge 
of the affairs of the Settlement to establish as few of them as 
possible, and only such which years of observation and public 
opinion at the Settlement made and approved. These rules, there- 
fore, are few, but the following of them have been the means of 
preserving the peace. 

Each leper has the right to select a building spot wherever 
he pleases, provided the place is not essential for purposes of the 
Board of Health, and he is therefore required to notify the super- 
intendent. Each leper on arrival at the Settlement has also the 
right to select the family or company he desires to live with, pro- 
vided, however, they do not object to it. If they object, he is 
given a place with others who are not adverse to it. 

Lepers building houses at their own expense, have the right 
to sell those houses again to other lepers, for lepers to live in. 
All houses built by lepers at their own expense, therefore owned 
by them, are, nevertheless, considered to be under the control of 
the Board, if to assert such a control, for good reasons, should 
become necessary. 

Lepers trusting one another with money or other things must 
do so at their own risk, nothing is done for them, officially, by 
any officer of the Board. 

Claims against deceased lepers for services rendered during 
their last illness are respected, if testified to by the leper before 
death and in presence of the chief officer of the Settlement; and 
if his heirs do not pay the disputed amount, his property, if he 
leaves any, is sold and sufficient of the proceeds is paid for such 
services. 

The property of a leper who dies without heirs at the Settle- 
ment or assigns, is sold by the sheriff of the Board and the pro- 
ceeds are forwarded to the president of the Board of Health, and 
the death of the leper is advertised in the papers that his heirs 



278 THE PATH OF THE DESTROYER 

may come forward and claim what he left. Wills left by lepers 
are also carried out by the Board, provided they are satisfactorily 
made out and properly witnessed. 

Drinking intoxicating beverages is forbidden, and persons 
found drunk are punished with twenty-four hours' imprisonment. 

Making intoxicating drink from potatoes or ti root is likewise 
prohibited and punished, and all material used in making the same 
is confiscated and destroyed. 

Liquor for the use of lepers and kokuas is not allowed to enter 
the Settlement, and suspicious looking packages when they come 
ashore are opened. If liquor is found, it is confiscated and des- 
troyed or sent to Honolulu to the marshal, to whom opium, if 
found, is also sent. 

Gambling is also forbidden at the Settlement, and guilty 
persons are punished. 

For the kokuas, the same rules are applied with some addi- 
tional ones. 

Every able-bodied male kokua gives one day's labor to the 
Board per week, for which he enjoys all the privileges and benefits 
of the place. 

Kokuas deserting their leprous wives or husbands, on whose 
account they were permitted to live at the Settlement, are told 
to leave. 

Kokuas repeatedly guilty of disorderly conduct or gross im- 
morality are likewise ordered to go. 

Every kokua can leave the Settlement when he pleases, but 
he cannot return without a special permit from the president of the 
Board of Health. 

Kokuas guilty of crimes or misdemeanors, are tried according 
to the laws of the Kingdom. 

These are, substantially, all the rules which have thus far 
been observed at the Settlement, and, with the exception of the 
unfortunate occurrence last November, already mentioned, affairs 
have gone very smoothly during the past period. 

During the past twelve or fifteen months the lepers have had 
a much better opportunity to avail themselves of medical attendance, 
than they have ever had before, having had the services of a resi- 
dent physician during the greater portion of this time. 

The live stock now running on the pastures belonging to the 
Leper Settlement consists in 235 horses, 288 mares, and 74 colts — 
in all, 579 horses; 40 cows, 18 steers, 25 heifers, 10 working oxen, 
1 bull and 25 calves — in all, 119 cattle; 20 jackasses and 3 mules — 



THE PATH OF THE DESTROYER 279 

in all, 23 ; making a total of animals of 739 head now running 
on the land. 

Suggestions for further improvement of the condition of the 
lepers and additional comforts, I have but few to make. 

Since the discontinuance of allowing lepers the choice of re- 
ceiving the cash value, in lieu of their weekly food rations, many 
of them have become rather poor; they do not plant as much as 
they used to, as they cannot sell their produce ; it ceases, with 
them, to be an object to raise it. 

I beg, therefore, to recommend the re-establishment of the 
system of giving them the choice to receive either the food itself 
or cash in lieu thereof, besides providing means as much as possi- 
ble to enable them to earn a little money, such as by raising po- 
tatoes and purchashing them again, as used to be done for the 
supply of the hospital, and others who very often prefer them to 
paiai, rice or bread. They will then be able to supply themselves 
with some additional clothing and other necessities, for, as already 
said, "six dollars per annum" is insufficient to clothe anybody. It 
does not cost any more to give them cash in lieu of. food, rather 
the contrary, and were it only practicable to adopt the plan of 
giving them all cash in lieu of food and meat, it would very 
much simplify the management of the place and be less expensive. 

Whilst I do not wish to deny the desirability of laying a larger 
water pipe, and extending the same to Kalaupapa, I must say 
that no absolute necessity for it exists, but should means be at 
hand and permit it to be done, I would recommend that it be done. 
And in that case, I would still advise obtaining the water from an 
abundant and unfailing source, by which Kalauwao, Makanalua 
and Kalaupapa and the entire Settlement can be supplied at once, 
for almost any desired purpose, than to obtain the supply from 
springs which are too much dependent on our irregular and un- 
certain rainy season, even should it cost a little more. 

I would also recommend the erection of a new slaughter- 
house, the present one is getting old and in a place where it is 
difficult to be kept clean, and put in a place where it can be sup- 
plied with water from the pipes, and save the expense of carting 
the same. 

Furthermore, I consider it an advantage, when providing the 
Settlement with beef-cattle, to obtain a larger number at once; 
(orders to send cattle to the Settlement to fatten on the pastures, 
have repeatedly been sent to Meyer. — Secretary Board of Health), 



280 THE PATH OF THE DESTROYER 

sufficient, perhaps, to last three months, that they may derive some 
benefit from the extensive pastures. 

As a rule, cattle lose in weight for the first two weeks after 
being landed, owing to change of place and pasture, but will soon 
regain what they have lost, and probably add considerably to 
their weight. 

To the request, what my experience and observations during 
these years of intercourse wkh lepers and others have taught me, 
relating to the contagiousness or uncontagiousness, heredity and 
causation of leprosy, I will give the result, which may be taken 
for what it is worth. 

"In the face of so much evidence of its spreading in so short 
a time as it has done on these islands, it is hard to conceive how 
anybody, professional or non-professional, can doubt the communica- 
bility of leprosy. It is simply the extreme slowness of its action 
and development, the apparent immunity from it, which so many 
seem to possess, and the imperceptible manner of its communica- 
tion, which could have led to the conclusion that the disease is 
not contagious." — Dr. Mouritz. 

I arrived on these islands in 1850, and very little, if anything 
was then known of leprosy. About the year 1857, I first heard 
of its appearance amongst natives, under the name of Chinese 
disease, or in Hawaiian, "Mai Pake." It was recognized by the 
few Chinese then on the islands, and this has given it the name of 
"Mai Pake" here, and not because it has been introduced here by 
the Chinese. It is much more likely that it came to these islands 
through the mixed crews of whale ships, which had negroes, black 
and white Portuguese, and men of other races, coming from 
countries where leprosy was, and still is, prevalent. 

In about 1859 or 1860, I saw on this island the first case of 
leprosy; it was a young man, he died with it in less than three 
years. The young man's mother took care of him, probably, and 
in 1868, she showed signs of leprosy, and died a leper at the Leper 
Settlement. I have known these people well, for they lived in 
my neighborhood. I only mention this one case, although I have 
account of others. And at the Leper Settlement, whilst there are 
many cases where people have lived together for many years with- 
out showing visible signs of leprosy at present, there are enough 
who do, and, as I reported before, fifty-two kokuas alone, have be- 
come lepers during the past two years, or declared to be lepers, 
by the physicians attending. Again, a number of foreigners of 



THE PATH OF THE DESTROYER 281 

various nations — American, English and German — have become 
lepers. 

Is it reasonable to suppose that all these men would have 
become lepers had they remained at home where they were born? 
They became lepers, because they came here, to a place where 
leprosy was prevalent, and exposed themselves to it. 

Leprosy attacks the robust as well as the delicate, but it 
appears that people with syphilitic and broken-down constitutions 
are more apt to become its victims. That no more foreigners have 
contracted the disease than they have, is simply owing to their 
better mode of living and care they take to avoid coming in con- 
tact with leprosy, and it may be that they possess a great degree 
of immunity. 

The disease appears to me also to be hereditary, and I will 
give a short history of a couple, a man and his wife, living also 
in my vicinity. Both man and wife are strong and hearty look- 
ing people, they show no outward signs of the disease, yet their 
children at the age of six or seven years became lepers one after 
the other, several of them were taken to the Settlement years 
ago, and there died lepers, and they have now with them another 
child, also a leper. How did these children become lepers? The 
husband's mother died a leper, the wife's father likewise. Is 
here not reasonable belief that these children were born with 
the germ of the disease in them, and that it was transmitted to 
them through their grandparents? Similar cases exist or have 
existed at the Leper Settlement. Another significant fact is 
the great number of cases of leprosy existing, where other and 
older members of the family of such cases are lepers or have died 
with it. 

The cause of the disease appears to me to be more or less 
speculative, by taking a general view and comparing the same with 
other diseases, it is not improbable that leprosy is caused very 
much in the same manner as they are. If it be true that like 
causes, under like circumstances or conditions, always produce the 
same effect, or similar effect, it must be evident that all diseases, 
running a known course, from that visible beginning to the end, 
must have had always the same origin, each disease peculiar to its 
kind, very much like the sprouting and growing of seeds of dif- 
ferent plants. 

What this origin of leprosy or other disease consists in I do 
not pretend to know; it may be a parasite or organism of an in- 
conceivably small size, which enters the body, and under unknown 



282 THE PATH OF THE DESTROY ER 

conditions develops and reproduces itself until it has taken pos- 
session of every part of the body, including the organs of re- 
production. 

Until the true cause of the origin of leprosy has been dis- 
covered, there does not appear to me to be much hope of arresting 
the progress of the disease or effecting a cure, and no other means 
can be expected to stem the spread of this scourge than the 
most merciless and rigid enforcement of the law of segregation. 
It would prove to be the most merciful in the end. Twenty years 
of segregation have now been practiced. What is the result? 
There are as many lepers as ever, more than in the commencements 

Halfway measures are here of no avail, they simply amount to 
a constant repetition of those heart-rending scenes, experienced by 
so many, of separating husbands from wives, parents from chil- 
dren, brothers from sisters, and without accomplishing the impor- 
tant purpose of saving the rest of their fellow-men, and for which 
they were required to suffer, and willingly gave up their liberty. 

I am fully aware of the insuperable difficulties encountered 
in carrying out the law of segregation on these islands, and there- 
fore doubt the possibility of having it carried out to the extent 
it ought to be. 

There is, however, one hopeful sign, the disease appears to 
assume a milder form, and the number of the very bad cases, of 
which there were so many in former years, is very much smaller 
and the disease appears to progress slower. 

I have the honor to be, sir, 

Your obedient servant, 

R. W. MEYER, 
Agent Board of Health. 



BROTHER JOSEPH DUTTON 

Soldier, Trappist Monk, Soldier of the Cross. 

Brother Joseph Dutton, of Kalawao, Molokai, the indefatigable 
worker amongst the lepers during the past, thirty years, is a veteran 
of the Civil War. He was an officer connected with the Army of 
the Cumberland, and was then known as Lieut. Ira B. Dutton, of 
Co. "B," 13th Wisconsin Volunteer Infantry, and had a splendid 
record as a soldier. 

He was born on April 27, 1843; his boyhood was passed at 
Janesville, Wisconsin, and in his youth he displayed the same ex- 
cellent qualities as he did in the Army, and has done during the 
past thirty years at the Leper Settlement, Molokai, Hawaii. 

In the summer of the year 1861, Dutton enlisted in the then 
recently formed Co. "B," 13th Wis. Vol. Inf. He served the 
length of the war, some four and a half years. The record of his 
army service is as follows: 

Quartermaster sergeant, 13th Wis. Inf. to February 10, 1863; 

Second Lieut., 13th Wis. Inf., Co. "I," February 10, 1863; 

First Lieut., 13th Wis. Inf., Co. "I," February 15, 1865; 

First Lieut, and regimental quartermaster, March 24, 1865. 

He was strongly recommended for appointment as captain and 
H. Q. M., U. S. Vols., by Major-General Geo. H. Thomas, Major- 
Generai J. L. Donaldson, Major-General L. H. Rosseau, Major- 
General Robert S. Granger. 

Lieut. Dutton was on the staff of the last named officer from 
June, 1864, to October, 1865, the end of the war. 

Col. A. Wills' testimony of Lieut. Dutton's value as a soldier 
is herewith given : 

"We were in the Army of the Cumberland together as officers. 
Dutton was a handsome fellow, and one of the best and bravest 
officers in the army. He was complimented in official orders for 
bravery. At the close of the war in 1865, Dutton was mustered 
out of the service, and I then engaged him as one of my superin- 
tendents in the locating and purchasing of National Cemetery lands 
in the Southwest. He was later engaged in caring for and trans- 
porting the bodies of the heroic dead of the battlefields, now in- 
terred in the cemeteries at Corinth, Mississippi, and Pittsburg 
Landing, Tennessee. After leaving the Government service, Dutton 
was employed by the Louisville and Nashville Railroad Company 
at Memphis, Tennessee; upon leaving the service of the company he 
engaged in religious work, became a convert to Catholicism, and 
soon after entered the Trappist Monastery at Gethsemane, Ken- 
tucky." 

Brother Joseph Dutton came to Hawaii in the year 1886, and 




Upper, Lieut. Ira B. Dutton, A. D. 1863. 

Middle, Lieut. Ira B. Dutton, A. D. 1877. 

Lower, Brother Joseph Dutton, A. D. 1907. 



THE PATH OF THE DESTROY ER 285 

in the early afternoon of Thursday, July 29th, of that year he 
arrived at Kalawao, calling at my house on his way to the Catholic 
Mission premises. He took up his residence with Fr. Damien, later 
occupying a small house near the residence of the priest. Since his 
arrival, now nearly thirty years ago, Brother Dutton has never once 
set his foot outside the boundaries of the Leper Settlement; but 
he could leave, if he so desired — he is not a leper. The Leper 
Settlement is under the control of the Board of Health of the Ter- 
ritory of Hawaii, and there is no law or statute on its books that 
can compel a non-leper to remain at the Leper Settlement, if said 
person desires to leave, move, or reside elsewhere. Any nurse, kokua, 
brother, sister, or other employee who is not a leper, is a free 
person. There is no such condition as involuntary confinement for 
a well person, but such statements find frequent place in certain 
newspapers. 

The day of his arrival Br. Dutton took luncheon with me, and 
I scanned him carefully. He had come afoot from Kaunakakai, a 
port on the south side of Molokai, about nine miles from Kalawao. 
It is a hot, dusty, fatiguing trip, even on horseback, yet Dutton 
showed no fatigue nor travel-stained clothes. He wore a blue 
denim suit, which fitted his well-knit, slim, lithe, muscular figure. 
He stood about five feet seven inches tall, had dark brown hair 
and grayish-blue eyes, low voice, placid features, and pleasant smile ; 
he was reserved and thoughtful, had nothing to say about his past 
life nor the reason for his seeking seclusion and work at Molokai, 
and turning his back on the world forever. 

Brother Dutton soon demonstrated that leprosy had no power 
to instil fear in his mind. For many months after his arrival, his 
daily routine, from daybreak to dark, was cleaning and dressing the 
sores, ulcers, and other skin troubles; removing carious and necrosed 
bone — all of the type that leprosy inflicts on mankind. He was 
methodical and accurate in his work, and quick to learn the rudi- 
ments of medicine and surgery. I started him dressing the wounds 
and sores of the leper proteges of Fr. Damien, and showed him 
(Dutton) the method of affixing dressings by properly applied 
bandages and other appliances. Within a very short period he he'd 
become so apt that he surpassed his teacher; in brief, "whatever Br. 
Dutton undertook to do he did it well." 

He always seemed to find time to attend to the numerous 
duties that fell to his lot, the more his work expanded the bettei 
he seemed to like it. He possessed a DIVINE temper, nothing 
could ruffle it, no vulgar or angry speech ever emanated from his 
lips; although his clothes were cheap, rough, and uncouth, he was 
always dignified and commanded respect. He never ceased to be 
neat and clean, and I have always believed this was his salvation 



286 THE PATH OF THE DESTROY ER 

and protection from leprosy. I enumerate some of Br. Dutton's 
manifold duties performed daily: Fr. Damien's companion, secre- 
tary, servant, nurse, and other menial work, sexton, sacristan, ver- 
ger, purveyor for Fr. Damien's Homes and his household, hospital 
steward, dresser, clinical clerk, later manager of the Baldwin Home, 
sanitary engineer, architect, landscape gardener — the site of the 
Baldwin Home was formerly an unsightly pile of rocks, note the 
transformation, as shown in the picture. Br. Dutton was also post- 
master. For years, single-handed and alone, he filled well all of 
the above offices. 

Br. Dutton will be seventy-three years of age on April 27, 1916. 
His services have been invaluable to the Board of Health and all 
the lepers; his earthly reward has been board, lodging, and a few 
dollars a month, but his greatest and most cherished recompense has 
been the love and esteem of those afflicted persons he has had charge 
of, who number at the Baldwin Home alone 1,148 to July, 1915. 
This Home opened in the year 1894, for single men and friendless 
boys, comprises forty-five houses, and has an excellent sewerage sys- 
tem. The grounds are well kept — have a forest of 5,000 eucalyp- 
tus trees, a large number of Samoan cocoanut trees, all planted 
under the supervision of Br. Dutton. 

During his thirty years of residence, great changes have taken 
place; grass houses, lean-tos and shacks have given place to com- 
fortable cottages with neat gardens; the meagre water supply has 
been supplanted with an abundant and never-failing source, suffi- 
cient for a modern city. These improvements, begun in the year 
1887 (due in the main to the energy and forcible personality of 
the then Minister of the Interior, Lorrin A. Thurston, ex-officio 
member of the Board of Health, and in later years — the nineties — 
to William O. Smith, many years president of the Board of 
Health), are still in progress, until the Leper Settlement has reached 
a degree of efficiency, that, it is unquestionably the foremost insti- 
tution caring for lepers in the whole world. 

I add, in concluding Br. Dutton's life history, he has always 
been careful, cleanly, and prudent whilst in contact with leprosy; 
and after thirty years of intimate association with the disease he re- 
mains unscathed. 

THE CHARLES R. BISHOP HOME, KALAUPAPA 

The noble, devoted, and priceless work carried on at this Home 
fcr leper girls and single women, is beyond all earthly praise and 
approval. The venerable and saintly Mother Superior Mary Anne, 
and her Sister companions, are prototypes of Martha and Mary and 
other holy women of the Biblical times. The Catholic Sisters dread 
publicity, hence the history of their lives, devoted to the service of 
God, cannot be written or printed. 




REV. CHARLES M. HYDE, D. D. 
1884 A. D. 



REV. CHARLES M. HYDE, D. D. 

Dr. Charles M. Hyde arrived in the islands May 31, 1877, 
and died in Honolulu, October 13, 1899, aged sixty-seven years. 

Extract from "The Friend,'' November, 1899: "Dr. Hyde's 
executive ability and intelligence made him a trustee in many 
educational and other institutions — notably Oahu College, Kame- 
hameha Schools, and the Bishop Museum. 

In each of these he has occupied a leading position ; in the 
organization and development of the Kamehameha Schools, his has 
been the leading hand in the work * * *" 

(For the above information, I am indebted to Mr. Thos. G. 
Thrum, eminent statistician, and foremost in knowledge of all 
matters pertaining to the Hawaiian Islands.) 

Glancing over the dates of Dr. Hyde's arrival and death, it 
will be seen that the doctor had resided in Hawaii well over 
twenty-two years. I will add the following supplemental facts 
showing the wide scope of the doctor's life work and activities. 

"Prominent church worker, recording secretary of the Ha- 
waiian Evangelical Association, trustee on the Board of the Public 
Library, and head of the North Pacific Institute, a theological 
training school for young men of Hawaiian, Caucasian-Hawaiian 
and Chinese-Hawaiian descent, to ultimately fit them for ordi- 
nation to the priesthood." 

The doctor was scholarly, polished, and refined; belonged to 
to the best class of Americans, he came from New England. He 
rather reminded me of a college proctor or don, such as we have 
in European universities, or even the rector of the same institution. 

The doctor's disposition was placid and calm, his voice low, 
his features were handsome and refined, his eyes and the general 
expression of his features tended to sadness and thoughtfulness 
combined, his personal appearance was good. He did not amass 
wealth ; he was in no position to do so, he worked amongst the 
poor, opened his purse to them and gave them freely of his means. 

He once authorized me to make a certain purchase; I thought 
the limit price was 50% too low, and asked the doctor to allow 
me to use my discretion and give more, rather than lose the pur- 
chase. He answered, "I cannot afford it, my purse is strained 
to the utmost ; if you cannot obtain it at the price named I must 
go without it." This is pretty good proof the doctor was not 
wealthy. 

My first meeting with Dr. Hyde occurred in September, 1884, 



THE PATH OF THE DESTROYER 289 

at Waialua, Oahu, at the supper table in the home of the vener- 
able and motherly lady, Mrs. Ursula Emerson, of original mis- 
sionary stock. 

The doctor and I spoke not, no introduction being made. 

VISIT TO THE LEPER SETTLEMENT 

My second meeting with Dr. Hyde took place on the after- 
noon of Wednesday, September 2, 1885, at Kalawao, Molokai. 
The doctor had landed at Kalaupapa from the palatial steamer 
"Mokolii," alias "Mud Hopper," of ninety-six tons burden. 

It was his first visit to the Leper Settlement, his business was 
to look after "church matters'' and also consecrate the newly 
erected Protestant church at Kalaupapa. He accepted such hos- 
pitality as I could extend to him, and remained in the Settlement 
some weeks. 

During the following days Dr. Hyde was busy with church 
affairs; later on he made a careful examination, investigating fully 
the schools and homes which Father Damien had founded for the 
orphan and friendless children. The doctor marveled greatly 
at the vast amount of work undertaken by Father Damien, and 
the promising results obtained with such a paucity of material. 
Dr. Hyde emphasized the benefits that would accrue in having 
more commodious and up-to-date buildings in every respect, for 
girls and single women, for boys and single men ; nursing was also 
debated and the conclusion reached that paid, trained foreign 
nurses were out of the question, Sisters and Brothers of Catholic 
organizations being alone available and promising success. Father 
Damien only too eagerly acquiesced and hoped ultimately to see 
those changes carried out. 

RESULTS OF DR. HYDE'S VISIT 

Dr. Hyde's visit was directly and indirectly of untold benefit 
to the lepers. The doctor had the ear and confidence of wealthy 
men connected with the then Fort Street Church, now Central 
Union, both Mr. Charles R. Bishop, and Mr. Henry P. Baldwin 
of Maui, were connected with this church. 

The congregation and membership of Fort Street Church 
was then the wealthiest and largest in the islands, and Dr. Hyde's 
visit to the Leper Settlement ultimately brought about, the de- 
sired result. A few years afterwards, excellent and commodious 
homes were built by Mr. Charles R. Bishop at Kalaupapa for 




FORT STREET CHURCH, CORNER OF BERETANIA, HONOLULU. 

In the year 1892, this building was dismantled; the congregation moved 
to their handsome new church at the corner of Beretania and Richards 
streets, called "Central Union." 

After the destruction of the "Bethel Church," its congregation amalga- 
mated with the Fort Street Church, and subsequently with "Central Union." 



THE PATH OF THE DESTROY ER 291 

girls and single women, and by Mr. Henry P. Baldwin at Kala- 
wao, for boys and men. Both these donors are dead. 

Mr. Joseph Dutton was put in charge of the Baldwin Home 
and Mother Superior Marianne in charge of the Bishop Home, 
and both these parties still survive, and still are active in dis- 
charge of their duties. 

These homes built by Protestant dollars are in charge of and 
administered by Catholic Sisters and Brothers. 

If Hawaii nei is the "Melting Pot" of the numerous races 
which inhabit its islands, it can also be truly said that Hawaii is 
also the "Melting Pot" of religions and sects, where all dwell to- 
gether in peace and amity. In no other country has the Brother- 
hood of Man and the Sisterhood of Woman reached such an 
advanced stage as in Hawaii. We have no beggars! We have 
no poor houses! How many other countries can assert the same. 

PARTIAL AND IMPARTIAL DONORS 

In former years only four denominations existed in Hawaii — 
Protestants, comprised of (1) American Congregationalists, and 
(2) Episcopalians, chiefly British, (3) Catholics, (4) Mormons. 

The chief wealth and power (as I have before stated) was 
in the hands of the American Protestant church (original mis- 
sionary church.) 

Today the missionary children and grandchildren, are the 
chief supporters and voluntary benefactors of the Leper Settle- 
ment; the Catholics coming next. 

The Episcopalians had no place of worship at Kalawao, the 
zeal and activity of Father Damien took most of them into his 
fold. When I was at the Settlement, the Catholics, Calvanists 
(Missionary Congregationalists), and the Mormons all had their 
own church buildings. 

There also existed certain adherents of the royal families of 
Hawaii with strict dividing lines; the followers of Mrs. Bernice 
Pauahi Bishop, the most numerous, haughty and distingue, then the 
followers of Queen Emma, and lastly the followers of the reign- 
ing Kalakaua dynasty. Quite naturally gifts and donations from 
each of these royal sources were distributed to their partisans. 

In marked contrast was the distribution of gifts and dona- 
tions to the lepers for Christmas, furnished by the members of the 
various churches in Honolulu; especially impartial were the do- 
nations from the missionary children, they were for all, irre- 
spective of church or creed. 






292 THE PATH OF THE DESTROYER 

Money and other gifts were placed in my hands with no re- 
strictions whatever — "Give to the most needy" was the injunc- 
tion. All of which goes to show that the people of Hawaii are 
remarkably liberal and progressive in their ideals, and set a 
shining example to other countries to follow. 

During the term I held office as physician to the Leper Reser- 
vation, the pastor in charge of the Protestant religious work was 
the Rev. J. Hanaloa; he was past sixty years of age, semi-blind 
and enfeebled; he was burdened with a sick wife, a victim of the 
nodular form of leprosy. This condition of his household naturally 
hindered him in his work. He was the type of old Hawaiian, 
who is rapidly passing away; minded his own business, frowned 
down upon drunkenness, card playing, and other occupations that 
lead to nocturnal orgies; his rebukes were given in such a mild 
manner that the sinners could take no offense. 

The Rev. Hanaloa had been brought up under the tutelage 
of the Rev. J. S. Emerson and his wife Ursula, and his (Hana- 
loa's) religious and other pastoral work did them much credit at 
the Leper Settlement. 

Oliver Goldsmith has informed us in his beautiful and soul- 
stirring poem, the "Deserted Village," of the village pastor, who 
passed rich at £40 a year — $200. The incumbent of the pastorate 
at Kalawao, Molokai, received a salary somewhat less, but it 
was materially added to by Mrs. Rice (Mother Rice) of Kauai, 
who always had a kind word and money for the poor and needy. 
Another worthy, generous, unassuming gentleman also contrib- 
uted to the stipend of the Rev. J. Hanaloa — the late James B. 
Atherton, who deceased April 7, 1903. 



PART IV. 



REPUBLISHED BY REQUEST 

REPORTS 
ON 

LEPROSY AND THE LEPER SETTLEMENT 
Thirty Years Ago 



REPORT OF HER MAJESTY QUEEN KAPIO- 

LANI'S VISIT TO MOLOKAI, BY H. R. H. 

PRINCESS LILIUOKALANI, 

JULY, 1884. 

To His Majesty the King: 

Sir: I have the honor to submit the particulars of Her 
Majesty's visit to the Leper Asylum on Molokai, whom, in 
obedience to Your Majesty's wishes, I accompanied thither. The 
steamer "Waimanalo" having been placed at the disposal of Her 
Majesty by Hon. J. A. Cummins, the party embarked early on 
Saturday, the 19th of July, 1884, leaving Honolulu at 3 a. m. and 
arriving at Waimanalo at 8 a. m. that morning. 

The weather proving favorable on Monday morning, we left 
that port for Kalaupapa, reaching our destination in the after- 
noon. At 4 p. m. the party consisting of Her Majesty the Queen, 
Hon. J. A. Cummins and lady, who were in attendance upon Her 
Majesty, Dr. Edward Arning, and Mr. C. B. Wilson, comptroller 
to my household, landed and were received by Ambrose Hutchi- 
son, the assistant superintendent, Rev. Father Damien, and Rev. 
Father Albert, who escorted the party to a house where a large 
number of the patients were assembled. 

The Hon. J. A. Cummins addressed the people and stated 
the object of the queen's mission among them. 

Her Majesty then arose and with the usual salutation of 
"Aloha Oukou," briefly addressed them as follows: 

"With love I greet you all. My heart-felt sympathy and 
that of His Majesty the King, your Father, is with you in your 
affliction. The King has sent His Sister, the heir apparent, to 
accompany me in this mission, to show his love to you. I also 
bring to you the love of the people of Honolulu, the ladies and 
gentlemen, natives and foreigners, and those of the other islands 
who have assisted me in raising the necessary funds and contribu- 
tions for your relief. 

I have been made familiar with your letters to me, and pe- 
titions to the Legislature, and whatever remarks you may have 
to make we will be pleased to hear them while we are with you. 
The principal object of this mission to your asylum is to 



296 THE PATH OF THE DESTROY ER 

know your condition, and to render such assistance as may be neces- 
sary for your comfort." 

The people were much moved with the queen's remarks. 
The assembly standing during the address. At the conclusion of 
Her Majesty's remarks, Kailikapu made the following address: 
"Your Majesty, Your Royal Highness, and gentlemen, I must, 
first, on behalf of my fellow sufferers, express to you our warm 
and heart-felt feeling and thanks for this exhibition of your 
tender love and affection towards us, your afflicted people. I have 
been an old inmate of this asylum, and this is the second time I 
have been removed from Honolulu to this place, where I suppose 
I must remain like my afflicted fellows to linger out a miserable 
existence without a hope of cure; away from the comforts of 
home and the society of family and friends. Since my last re- 
moval to this place, by a close observation of the workings of the 
disease here, I have become thoroughly convinced of the non- 
contagious nature of the disease. Instances are numerous here 
where men afflicted with the disease have been accompanied by 
healthy wives, who have lived with them, and nursed them for 
years until death, without the wife becoming afflicted by the dis- 
ease, or in the other case, the husband. Children, too, have been 
born of diseased parents and reared among the lepers, without 
contracting the disease; several such cases are among us now. Such 
being the case, I cannot see how the disease can be called con- 
tagious or why we are segregated in an isolated place, where our 
most urgent wants are but poorly supplied. Poor food, insuffi- 
cient as regards quantity, and want of proper care and nursing, 
are prominent among the ills of which we have to complain, and 
if the government cannot supply these as they are supplied to us 
when at home, they should return us whence we came. 

Our rations consist of 21 lbs. of paiai, 7 lbs. of beef, and 
1 lb. of sugar per week. Of this 7 lbs. of beef, 5 are often made 
up of bone. This is sufficient for one person only for three days, 
and the remaining part of the week he has to go without food. 
Those living at Kalaupapa have to travel five miles to get their 
rations, and there being no means of conveyance supplied, such as 
are too feeble to travel that distance, and have neither horses of 
their own to travel on, or friends to assist them, are often de- 
prived of food. Many poor, disabled people, too, are unable, in 
their feeble and mutilated condition, to prepare their own food 



THE PATH OF THE DESTROYER 297 

after they have got it. When the rainy season sets in the streams 
would be swollen, and these feeble ones would sometimes be so 
•exhausted that they were unable to cross the stream on their 
way home, and therefore had to wait until the storm and freshet 
subsided before they were able to cross. From this cause many 
have taken cold, and died in consequence. 

An order for six dollars' worth of clothing is allowed per 
year to each patient, which they get filled at the store of the 
Board of Health. This is altogether insufficient. One woolen 
shirt and a blanket is all it will buy. On account of being thus 
poorly supplied with clothing, some died of cold, especially in the 
winter months. One great need also is wholesome water to drink 
and use for preparing food. Now we have to go three miles for 
water and pack it ourselves, and very often we are compelled 
to use the brackish water from a well near the beach. 

I will also speak of another matter — that is, of the healthy 
children amongst us. Why are such children (many of whom 
are well grown, and without any sign of the disease about them), 
allowed to remain here and become patients through contagion? 
Why are they not taken elsewhere and properly cared for?" 

The second speaker, Mr. Kahanapule, said: "Greeting to you 
our Queen, and to your Royal Highness and gentlemen: By the 
request of the patients now residing at Kalaupapa and Kalawao, 
I was selected from among their number to draft a petition in 
their behalf to be presented to the Legislature, now in session, in 
which was made a statement of our needs and a prayer for re- 
lief — a duty I was glad to perform. The confidence they have 
placed in me to act in their behalf, I now avail myself of on this 
occasion to make known to you what I believe to be our sorest 
needs; I speak in the interest of those people you now see 
around you, and more especially of those in crippled condition, 
unable to be present to meet you upon this occasion, and of those 
who have joined with us in showing our appreciation of the great 
love you have shown to us in the willingness with which you 
have crossed the dangerous ocean to meet us, and hear our appeals 
and relieve our necessities. Our needs are many. Foremost 
among them is the necessity of clothing, someone with authority 
to settle our difficulties, and satisfactorily dispose of them. At 
present we have to submit without appeal to the arbitrary ruling 
of Agent Meyer of the Board of Health, and are often incarcer- 



298 THE PATH OF THE DESTROYER 

ated for alleged offenses in a summary manner, and without a 
hearing of the case. 

It is the desire of many of us that a resident judge should 
be appointed, who will always be present to hear and determine 
in a proper manner many of the little grievances between the 
members of our colony, and also be empowered to punish justly 
any offence against the peace and good order of our community. 
Our general superintendent visits us only once during each quar- 
ter of the year, and remains altogether too short a time to make 
such investigations as are necessary to the end of justice. Es- 
pecially frequent are desertions in married life, and the annoyance 
suffered on this account is great. Many, today, amongst us are 
living in adultery, because they feel secure in their removal from 
the reach of the law. With the general government I have no 
fault to find, as every endeavor is being made to provide for our 
wants; but I do blame the Board of Health for its laxness in 
carrying out a proper system of supplying those wants which have 
been liberally provided for by the government. Our paiai, for 
instance, is landed at Waikolu Gulch, about five miles distant 
from Kalaupapa, and the patients of that part are necessitated 
to pack it themselves all that distance. This is a grievous task 
to many, while to those who are weak it is an impossibility. The 
place of landing, too, is so situated, and the road to it impassible, 
that in stormy weather travel there becomes actually dangerous, 
and at times pack-horses, together with their burdens, have been 
washed away and drowned, and men too have barely escaped 
with their lives. In such an event, those to whom the food be- 
longs are necessitated to go without their supply until a new lot 
has been received. After the paiai is obtained many of the more 
crippled are unable to prepare it themselves, and can have no 
water to mix it with unless they are willing to use the brackish 
water near the beach, which is entirely unfit for any such purpose. 

"Those who prefer it may, in lieu of paiai, have nine pounds 
of rice and seven pounds of hard bread per week. They are 
compelled to make the change when the poi supply is short, or 
when they are unable to go that long distance for paiai. But 
such food is not satisfying, even when we have eaten our fill with 
other kinds of food we are not satisfied. Poi is our natural 
food, and nothing could take its place. Kokuas who help the 
patients have to be fed out of their rations, and when this is the 
case the weekly supply of food is not more than sufficient for 
three days, and the unfortunate one goes part of the time hungry. 




QUEEN KAPIOLANI. 
Wife of King Kalakaua. 



300 THE PATH OF THE DESTROY ER 

Many of the patients have kokuas to prepare their food for them, 
otherwise they would go without food, and sometimes do, and die 
of starvation. What the previous speaker has said in regard to 
the insufficiency of warm clothing and the number of consequent 
deaths is perfectly true. If the government intends to keep us 
here, let the Board of Health be instructed to exercise a better 
care over our wants. Each of us has an allowance of six dollars 
a year." 

Mr. Ambrose Hutchison, who is under-superintendent of the 
entire Settlement, said: "Being myself an employee of the Board 
of Health, I feel it my duty to uphold the actions of the Board 
where they are defensible, but at the same time I feel it my duty 
to my fellow sufferers here that I should speak plainly of matters 
as they are. I concur in the statements made by the previous 
speakers with reference to the food supply, and the mode of de- 
livery. Their statements are not exaggerated. For those who 
are so crippled as to be unable to attend to their own wants a hospi- 
tal is provided; but their prejudices against the institution prevent 
many of them from availing themselves of the comfort there af- 
forded. Their dread of the place may be easily explained, when 
we take into consideration the fact that it was formerly a practice 
to send along with each patient, by the same conveyance, a coffin 
he was soon to occupy. Add to these things the fact that no 
proper care or nursing is provided, and the horror of the place so 
generally entertained by the patients is easily explained. The 
great, want here is the institution of more approved nursing facili- 
ties. The hospital patients should be also supplied with better 
accommodation generally, and be provided with a more appropriate 
place in which to take their meals. If to such provisions were 
added that of a resident physician and an efficient staff of nurses, 
the main source of objection would be removed, and then they 
might enter the hospital willing instead of avoiding the place as 
they do now. Could some Sisters of Mercy be induced to come 
up and remain among us, as is now the case at Kakaako, it would 
certainly be a great blessing. The nursing is now performed by 
kokuas, who receive no pay, and whose hearts are not in their 
work, and amounts to nothing so long as they attend to the wants 
of their own people. They go and come as they please, and pa- 
tients suffer much from their neglect. One thing I would like 
especially to call your Majesty's attention to, and that is among 
us are a number of children born of diseased parents, who them- 
selves are entirely free from all symptoms of the disease." 



THE PATH OF THE DESTROYER 301 

Taking in his arms a little girl about ten years old from the 
crowd, the speaker said: "Here is one of them, and there are here 
between fifty and sixty just such cases as this, and at various ages. 
These should be kept aloof from the diseased and properly cared 
for in a separate asylum, and not be allowed to remain where the 
chances are of so many of them becoming patients by contagion. 
I would urge upon the Queen and the Heir Apparent to have this 
matter attended to, and to allow the weight of their elevated 
positions and the great influence they possess to bear upon the 
Board of Health, in order to bring about the realization of so 
worthy an object. In conclusion I can only express my hope that 
this royal visit may be pregnant of future good, and may prove 
the harbinger of an improved moral and social condition among us." 

Two other speakers followed in substantially the same strain 
as the two first speakers; one of them, a young man of the age of 
thirty years, spoke at length upon the proposition for the appoint- 
ment of a resident judge, and told a piteous tale of the infidelity 
of his own wife, and his want of means of redress. He had no 
other complaints to make against the Board of Health. What was 
done for them was perfectly satisfactory, and they were all well 
provided for. A murmur of disapproval was at. once raised, and 
interfered with the continuation of his remarks. 

After making such visits as time would allow among the 
tenements of Kalaupapa, Her Majesty and company proceeded on 
horseback to the main settlement, arriving at about 7 :30 o'clock 
p. m. There quarters were provided for the royal party by Mr. 
Van Geisen in a new house lately built for the special accommo- 
dation of visiting physicians. At supper, the Rev. Father Damien 
was a guest. 

After breakfasting on the morning of the 22d, the party 
consisting of Her Majesty, attended by Hon. J. A. Cummins, Dr. 
Arning, Mr. C. B. Wilson, Mr. J. H. Van Geisen, and the 
undersuperintendent, Mr. Ambrose Hutchison, began to inspect 
the houses of the patients. 

In the first place visited there were nine patients, one of 
which was a very bad case. He had been twelve years at the Settle- 
ment and nine years in the Hospital ; his age being about sixty 
years. Three were about the age of thirty years, and the re- 
mainder boys between fifteen and seven years of age. 

To questions put by Her Majesty, they complained that their 
bedding (only mats), was too hard, their covering insufficient to 
keep them warm at night, and their food neither properly pre- 



302 THE PATH OF THE DESTROYER 

pared nor always sufficient in quantity. They complained also of 
neglect at the hands of the kokuas, to whom were detailed the 
work of administering their medicine and dressing their sores. 

They also expressed their desire for the attendance of a 
resident physician, who could prescribe for them in the many cases 
of inter-current diseases, such as bowel complaints and other 
troubles which were frequent among them. When questioned as 
to the conduct of the visiting physician, they said that his visits 
were so short, and his work so hurried, that no practical advan- 
tage was to be derived from them. 

In the second ward were ten patients, ranging in age from 
twenty-five years to seventy. Most of these cases seemed to be of 
the anaesthetic form of the disease, there being but comparatively 
little distortion of features. In the majority of these cases ringers 
and toes were either entirely wanting or in process of amputation, 
rendering the victims almost entirely dependent upon the help of 
others. Some had bound up their own ulcerated extremities them- 
selves after a primitive fashion. To the question asked whether 
or not such ulceration could be healed by the appropriate treat- 
ment, Doctor Arning answered in the affirmative, qualifying the 
statement, however, by saying that in some cases the healed sur- 
faces might again take on ulcerative action, that being the natural 
tendency of the disease. These patients uttered the same complaint 
as those previously visited; but complained especially of the neg- 
lect of the kokuas, and the difficulty they often experienced of 
getting a sufficiency of water regularly supplied them, notwith- 
standing the fact that there was an abundance of water on the 
premises. 

The third ward contained eleven patients, five of whom were 
sixty and seventy years old, three about thirty-five years of age, 
and the remainder between seventeen and twenty. One aged 
twenty-five years had totally lost his sight, and all his ringers 
and toes. This result of the disease required him to be fed by 
another patient of the ward. Among those was the old man 
Nakahuna, well known to all old residents of Honolulu as the 
vendor of Hawaiian curios there a few years since. He has had 
the disease about four years, and has been an inmate of the 
hospital at Kalawao for three years. 

Worthy of remark is the case of a woman named Kealahua, 
whom we met in this ward. She came to the Settlement about 
fourteen years (1869) since with her leper husband, who died 
there about seven years ago of the disease. She herself is robust 




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304 THE PATH OF THE DESTROYER 

and to all appearance without any symptoms of the disease about 
her, and is engaged by the Board to do the entire washing for 
the patients at the hospital, at a salary of $10 per month. She 
has been the mother of four children, one of whom died of acute 
disease without having developed leprosy, another of leprosy, the 
remaining two now living being lepers. (In the year 1888 this 
woman developed leprosy. — Author. ) 

The fourth ward contained ten patients, all of whom were 
women. Of these eight were between nineteen and thirty years 
of age, and two about sixty-five years. Among them was a young 
girl of about ten years who had accompanied her leper grand- 
mother there. This girl, after a careful examination by Doctor 
Arning, was pronounced to be free of leprous symptoms, and her 
removal recommended. The great complaint here seemed to be 
of the insufficiency of warm clothing and comfortable bedding. 

The fifth ward contains two rooms, in one of which were six 
young men between 16 and 20 years, all of whom were inveterate 
cases. In the other room were two native boys and two Chinamen. 
One of the boys was threatened with blindness from the disease. 
Insufficiency of warm clothing was also their complaint. 

The sixth ward was occupied by one patient only, who was in 
the last stage of the disease. He was horribly deformed in features 
and his eyes totally blind. He seemed to be undergoing intense 
suffering, and was muttering, throwing himself about in the wildest 
manner. Doctor Arning was called in and gave him a draught 
which seemed to give speedy relief ; and at the end of half an hour 
he was sleeping quietly. Such cases as this prove the value a resi- 
dent physician might often be. 

In the seventh ward were four very bad cases. One in par- 
ticular was noticed, where, though the face showed little disfigure- 
ment, the whole trunk was a mass of inflamed or suppurated tuber- 
cles which emitted an offensive smell unbearable to stand. In 
noticing this patient the doctor observed that with proper medical 
treatment, such cases as these might be greatly alleviated and a 
great deal of unnecessary suffering be prevented. 

In the eighth ward were three boys, between the ages of 
fourteen and seventeen years, all bad cases. They seemed diffident, 
had no complaints and nothing otherwise to say. 

The lock-up was next visited. The building is about 10 by 
15 feet is dimension, and contains two rooms about 6 feet long and 
9 feet wide respectively. These are poorly ventilated by small 
iron gratings situated on the leeward side of the building. In* 



THE PATH OF THE DESTROY ER 305 

one were two Chinamen, both sentenced to one months' con- 
finement on a charge of assault with a deadly weapon upon one 
of their countrymen. In the other was confined a native named 
Makahui, sentenced for burglary in the store of the Board of 
Health, and abstracting therefrom money to the amount of $240, 
his partner in the crime, one Naai by name, had terminated his 
own life shortly after sentence, by suspended himself from the 
grating of his cell. 

The cooking arrangements are commodious, cleanly kept, 
and convenient; a cooking range being supplied sufficiently large 
to do the cooking for 150 persons. The poi room is also spacious 
and clean. 

As numerous descriptions of the Settlement generally, and of 
the hospital in particular, have heretofore been published, it will 
be unnecessary to give a further description. But here I may say 
that great credit is due to those in charge for the very neat and 
cleanly manner in which everything connected with the premises 
is kept. 

After leaving the hospital premises, the party next visited 
the storehouse, situated not far distast from the hospital and im- 
mediately across the road. Upon a close observation of the stores, 
all the articles provided appeared good, with the exception of the 
sugar, bread and salmon, the last mentioned article being so 
mouldy and soft as to be unfit for use; the sugar dark and dirty, 
of about No. 3 or No. 4 quality; and the bread tolerably good 
for medium bread, though inferior to that supplied to the Oahu 
jail. 

There are about 14 head of cattle butchered per week. Allow- 
ing (which, according to the statement of some butchers, is a 
large average) that each bullock weighed dressed, 350 lbs., and 
seven pounds per week of beef to an individual, the amount of 
beef slaughtered would supply only about 700 people ; whereas, 
there are at the Settlement, including the kokuas, a population 
averaging between 850 and 950 souls. 

The arrangements for slaughtering are most primitive; and 
the water supply insufficient for the cleansing of the meat. Ar- 
rangements, however, are now being made, whereby this defect will 
soon be remedied. A new reservoir is now in process of construc- 
tion near to the place of slaughtering, and designed to be filled from 
pipes connecting with the valley supply. 

The next subject which engaged the attention of the party 
was an inspection of schools under the charge of Rev. Father 



306 THE PATH OF THE DESTROYER 

Damien. The buildings occupied for this purpose are supplied by 
the Board of Health, one of which is used for a boys' school and 
the other for girls, being situated in near proximity, and on the 
opposite sides of the road. Both are within the vicinity of the 
mission church. 

In the girls' school are sixteen pupils in all, ranging in age 
from nine to seventeen years. Among these was the young girl 
Luahiwa, of whom mention was made by Dr. Fitch in his late 
biennial report. Of all these scholars she bore the worst marks 
of disease. Out of these children there were four between nine 
and eleven years of age who exhibited no external signs of the 
disease; but one, upon careful inspection by Dr. Arning, was de- 
clared to be in the incipient stage of disease. 

In the boys' school were twenty-six pupils, all of whom were 
well marked with the disease. 

The pupils of each school are separately lodged and fed. They 
are all either orphans or friendless, and under the immediate care 
of Father Damien and a native woman named Kuilia, not her- 
self a leper. 

After leaving the school the party proceeded on horseback, for 
the purpose of inspecting the old and the newly proposed sources 
of the water supply of the Settlement. The system now in use, 
and which has been so almost since the establishment of the Set- 
tlement, has its source in the valley of Waileia. It is now 
recognized by the Board as inadequate to the needs of the place, 
and a proposition has been made to bring the water from Waikolu 
Valley — about two miles further on. Waikolu is the place where 
the paiai supply of the Settlement is landed and dealt out to the 
patients, being about three and a half miles from Kalawao, and 
five and a half from Kalaupapa. After traveling the road to this 
valley, one is forcibly struck with the force of the universal ob- 
jection made by the patients, to the great distance they have to 
travel for their food. 

The water supply here is abundant and never-failing, and 
capable of supplying the needs of a town larger than Honolulu. 
The scenery of this valley is grand. The numerous cascades dart- 
ing out in all directions from over the lofty precipices, the spray 
gracefully falling among the dense shrubbery and covering the 
green foliage as with gems of pearls. A sight seldom seen or 
surpassed in magnificence and beauty. 

In the valley are several acres of land now lying idle, which 
might be utilized at a small outlay, in the cultivation of taro and 



THE PATH OF THE DESTROYER 307 

other products for the use of the Settlement. The landing of 
two boat-loads of paiai during the sojourn of the party there 
afforded an opportunity of realizing the fact that a number of 
complaints, already enumerated, were not without foundation. The 
stream was so swollen by the rains which had been unceasing 
during our visit, that after a difficult landing had been effected, it 
was still more hazardous for the animals with their heavy packs, 
and they had to be forced to cross over the stream. 

After staying in the valley for half an hour, the party took 
the opportunity of inspecting a proposed new landing about half 
a mile from the hospital, thence returning to Kalawao and visiting 
on the way every house to be seen. Most noted among the houses 
visited were the dwelling of Kaulamealani, Napua, Kuanea and 
Kii. The two last named individuals were pitable objects indeed 
and entirely dependent upon the friendly assistance of their 
neighbors for what help they received. Their fingers and toes 
were almost entirely gone with the disease. With suppurated 
hands and stumpy fingers they had improvised rude bandages for 
relief. Hospital accommodations and aid were clearly needed, but 
in reply to the question put to them, they said that they had a 
horror of entering the hospital. 

Her Majesty, as well as others of the party, was much affec- 
ted at the touching sight of these two old women, utterly unable 
to help themselves, and promised every exertion on her part toward 
the removal of any objection that might really exist in the hospital, 
and that efforts hereafter should be used to render the place attrac- 
tive and not repulsive. As there was little time to spare, and as 
Her Majesty had promised to address the people of Kalawao be- 
fore leaving, she bade the sufferers a kind adieu, and the company 
wended their way toward the Settlement, arriving at the store 
where the address was to be given at three o'clock that afternoon. 
A large number of patients had gathered. Her Majesty proceeded 
to address them similarly as upon the previous occasion at Kalau- 
papa. At the conclusion of her address she was heartily cheered 
by the people. A few among them responded to Her Majesty's 
remarks, but as they were of similar tenor to those previously 
given, it will be unnecessary to quote them here. Upon our final 
parting, three cheers were given for their Majesties the King and 
Queen. 

Before leaving the house at Kalawao, the party engaged itself 
in planting several seeds of alligator pears and mangoes, taken 



308 THE PATH OF THE DESTROY ER 

from a large supply of such fruit seeds that had been brought by 
Her Majesty for distribution among the people. 

The landing was finally reached at about half-past seven 
o'clock p. m., after Her Majesty had made a slight detour in 
order to visit an extinct crater, Kauhako, whose basin is partially 
filled with sea water by a subterranean connection with the ocean. 
Before leaving the place, however, Her Majesty again visited every 
tenement in the neighborhood. Incidentally I would mention an 
interview which took place at the landing between one of the party 
and Keliikapu, one of the former speakers, several others being 
in the company. This man claims to have contracted the disease 
from vaccination, it having appeared about four years after. He 
asserted that through the same agency all of his schoolmates had 
died of the disease. In speaking of other matters he said that a 
great deal of bad management existed, rendering a loss to the 
government of about one-third of the cattle driven to slaughter 
over the precipitous road from Kalae, and thought it would be 
far less expensive on this account to land them from vessels at 
Kalaupapa. He said there was ample pasture in the district for 
several hundred cattle. 

He disapproved of the appointment of a resident judge, saying 
that such an office was unnecessary, and that such an idea had 
only originated in the brain of one who was looking forward to his 
own appointment. A foreigner, he said, would never suit as under- 
superintendent of the Settlement, as, owing to prejudice, his 
actions would often be misjudged, and trouble of a serious nature 
might ensue. Natives would be more likely to overlook or con- 
done the fault of one of their own race, than would be the case 
if the offender were a foreigner. He said that the present over- 
seer, Mr. Hutchison, was in every respect a good man for the 
position and universally esteemed in the Settlement. He thought 
there was urgent need of more hospital accommodation, and medical 
attendance and nursing. He said that not the least among their 
difficulties was that of obtaining wood for fuel. As it was now 
the patients had to travel far and climb the mountain themselves 
to get it. 

Upon a careful review of all the facts elicited by our visit 
and observation of the existing state of affairs, the following 
propositions have suggested themselves: 

1st. As the supply of water is manifestly inadequate to the 
needs of the population, it would be advisable to put into operation 
the proposed plan of bringing the water from the valley of Waiko- 
lu, where an abundant and never-failing source could be obtained, 




QUEEN LILIUOKALANI. 

Sister of King Kalakaua. 



310 THE PATH OF THE DESTROY ER 

and the supply so created should also be extended to Kalaupapa, 
where brackish and unwholesome water is now only obtainable. 
Here the water is often rendered absolutely unfit for use by an 
overflow of the tide into the well from which the supply is de- 
rived. 

2d. A resident physician and an assistant are needed, whose 
dwelling place should be in near proximity to the hospital, that 
being a central locality. The patients die in many cases from 
maladies, such as diarrhoea, dysentery and other complaints that can 
be treated, if proper medical aid was at hand. 

3rd. The hospital accommodation should be increased so that 
at least two hundred patients could be admitted. 

4th. If possible, Sisters of Mercy should be induced to 
lend their aid in carrying out the nursing part, and care of the 
hospital. 

5th. There should be an ambulance provided for the trans- 
portation of crippled patients, also two spring wagons for the 
more convenient delivery of beef and paiai to the lepers, at or 
near their dwellings. 

6th. It would be good to subsidise a small steamer, from 
80 to 100 tons, able to carry 20 or 30 head of cattle, 50 cords fire 
wood and the poi. This steamer should also be used for the 
transportation of patients from Honolulu to Kalawao. 

7th. Lepers who are unable to help themselves should be 
compelled to take shelter in the hospital. 

8th. For the treatment of children in the incipient stage of 
the disease, with a view to their cure, and also as an asylum for 
the otherwise healthy children where they could be kept apart for 
a reasonable time there should be two proper buildings provided in 
or near Honolulu, to be attended by a competent physician and an 
efficient nursing staff. 

9th. As so much complaint is made about an insufficiency of 
food and clothing, it might be advisable to increase the supply 
of the same, and to have the rations altered as follows: 

4 lbs. of beef delivered twice a week; 
15 lbs. of paiai delivered twice a week; 

1 lb. of salmon (for variety sake) per week; 

4 lbs. of mutton occasionally, in place of beef; 

2 lbs. of sugar, not darker than No. 2; 

5 lbs. of salt per month ; 

1 bar, 2 lbs., soap per month; 
y 2 gallon illuminating oil per week. 



THE PATH OF THE DESTROY ER 311 

I would suggest also a trial of canned meats, such as are 
put up in Australia for army and navy use, by way of variety as 
a substitute for beef, it might be found useful and economical. 

In regard to clothing, it would be advisable to supply each 
person with a certain amount for day and night wear, in place 
of an allowance in money for that purpose, as at present. Many 
misuse their money, and suffer in consequence. It would be far 
better to allow each person two suits of woolen clothes a year 
and two blankets, the same as is done at the Oahu jail. 

There is no reason why a moderately large herd of beef 
cattle, and milk cows could not be raised on the pasture lands 
of the Settlement. The beef cattle could be kept for cases of 
emergency, when weather might interfere with the regular supply, 
and the cows might be milked, more especially for the benefit of 
children and the sick. 

In the two valleys of Waikolu and Waileia, there is much 
land uncultivated which would be suitable for the growth of taro, 
if it could only be utilized, which I believe is possible, if proper 
inducements were offered to cultivators. 

It would be advisable that Waikolu should be abandoned as 
a place of landing, on account of the dangerous nature of the only 
road thereto; and that a boat landing be constructed near Kalawao. 
Such a plan is perfectly practicable and could be perfected with 
but little outlay. The road to the present landing place is for 
two miles of its length over lava rock, and overhung by craggy 
precipices from which frequent showers of stones are precipitated 
upon the road below, rendering travel dangerous to man and beast. 
A greater danger still exists in the frequent washing out of the 
road by the sea, making it on this account, in stormy weather, 
highly unsafe to travel. 

There should be a better system adopted in regard to the 
kokuas than at present exists. So far as efficiency and reliability 
are concerned, the present plan of giving the work of the place 
to kokuas is a failure. It is not to be expected of persons going 
there as they do, merely to serve their own immediate friends or 
relations, that gratuitous work could be voluntarily performed by 
them for others, and any compulsion in this matter is altogether 
out of the question; and yet it is upon their general help that 
reliance has, under the present system, to be mainly placed. 

The support of every kokua means so much less in the way of 
food, rations and other necessaries to every patient that needs their 
help, and the question of the propriety in allowing so many healthy 



312 THE PATH OF THE DESTROY ER 

people to place themselves without restriction in the way of con- 
tagion, is one to be taken into consideration. 

In closing these suggestions, I cannot help stating that the 
Settlement as an asylum for these poor unfortunate creatures is 
decidedly the best place for them for a place of strict isolation, 
and the condition of things is so much better than that at my for- 
mer visit in 1881. 

The party slept on board the steamer, which lay at anchor 
that night, and at 4:45 a. m. on the morning of the following 
day, left Kalaupapa for Honolulu, arriving at the wharf at 12 
o'clock m., after a smooth and pleasant passage across the channel. 

LILIUOKALANI. 



DR. STALLARD'S REPORT 

Honolulu, March 12, 1884. 

To Honorable A. S. Cleghorn, 

Member of the Board of Health. 

Dear Sir: In accordance with your suggestion, I have the 
honor to submit the results of my inquiries into the condition or 
the lepers, and into the administration of the sanitary arrange- 
ments intended for their benefit. My first visit was made to the 
branch hospital at Kakaako. I went through the establishment 
with Dr. Fitch; and at a more recent visit, I have had the oppor- 
tunity of conversing with one of the nursing Sisters. I was in- 
formed that this hospital was originally established for the purpose 
of segregating the recent and doubtful cases of leprosy which were 
to be submitted to careful medical treatment ; and in case of cure, 
discharged. It was also intended that those on whom the disease 
became fully manifest, should be transferred to Molokai. 

In every one of these objects the hospital has proved a failure. 
The segregation has never been complete. The granting of 
permits to visitors has always been exercised on a very liberal scale. 
The light palisading which surrounds the hospital, accords every 
facility for verbal intercourse with the inmates. It may readily 
be scaled from either side. It is notorious that men have obtained 
access to the female wards, and that inmates have paid visits to 
their city friends without the knowledge of the superintendent. At 
the gate of the hospital a crowd assembles daily ; and seats have 
been provided on both sides of the fence, where patients and 
friends sit in close communication. Stalls for the sale of various 
luxuries, tobacco, etc., have been frequently erected, and many 
articles are passed in and out without difficulty. 

This intercourse with the outside population has been freely 
carried on ; and there is, in fact, no real isolation. Furthermore, 
the proximity of the hospital to the city presents the strongest 
temptation, both to patients and their friends, to carry on for- 
bidden intercourse. This is prevented with difficulty, in case of 
criminals, by the erection of high walls, a method of isolation quite 
inapplicable to the case of lepers. If, however, by this or any 
other means the isolation of the lepers were made complete, the 
hospital would be converted into a prison ; the feelings of the 
patients and their friends would certainly be wounded deeply, and 
a revolt might be expected on either side. 



314 THE PATH OF THE DESTROYER 

Nor would complete confinement to so limited an area as that 
enclosed at Kakaako be justifiable in the treatment of a disease 
which is eminently characterized by weakness. For leprosy space, 
air, good food, abundant exercise and occupation are absolutely 
essential, and without them it is hopeless to look for improvement, 
and more hopeless still for cure. In Kakaako there was, at the 
time of my visit, great over-crowding; there were 200 inmates, 
but recently 39 have been removed; nevertheless the hospital is 
crowded to its full capacity. Nor is the surrounding air always 
pure. On one side is a salt marsh, and on the other an offensive 
foreshore; but if it were still possible to prevent personal communi- 
cation with outsiders, there is no guarantee of public safety, since 
no one has yet determined the exact manner in which the germs of 
leprosy are diffused and communicated. It is not long since it 
was believed that the contagion of smallpox would not pass the 
barrier of a few feet of air; but recent experience has shown that 
the erection of a smallpox hospital in a populous locality becomes 
a focus of contagion, over-leaping all barriers and spreading its 
deadly influence to the distance of a quarter of a mile. It is not 
impossible therefore that the germs of leprosy may be conveyed 
by mosquitoes, flies, and other insects over the short space which 
separates the hospital from the city. It is lastly a great objection 
to the position of suburban hospitals that they depreciate the value 
of surrounding property, and in case of Kakaako the position in 
front of the sea makes it a standing advertisement of the existence 
of leprosy, and a menace to all who dare risk danger of contagion by 
entering the port. But the most objectionable feature of Kakaako 
is the complete absence of any classification of the inmates; the 
practice of sending away the confirmed lepers has long since ceased. 
Apparently friends amongst persons high in authority are per- 
mitted to remain in spite of their condition, while those who 
have no friends are sent to Molokai, even before the hope of suc- 
cessful medical treatment has entirely passed away. 

The hospital has, in this way, lost its special character. New 
cases and old cases, those with but slight traces of disease, and 
others at the point of death, those with running sores and those 
without, are all mixed up, young and old, without any attempt at 
classification. 

Even males and females are not really separate; until recently 
the more able-bodied were placed, by necessity, with the permanent 
invalids for whom they were the only nurses and attendants. It 
seems to me a perfect outrage that any recent or doubtful case 



THE PATH OF THE DESTROYER 315 

should be sent to Kakaako. In this city I have seen cases of 
young men and women with some symptoms which indicate the 
probability of their being eventually lepers. Many of these young 
persons are well educated and have refined sensibilities. Until 
the exact mode of propagation is made out, such persons are unfit 
to remain in public schools or to mix with the children of private 
families. They belong to the class of suspected, and they pre- 
sent the hope of possible amendment and of cure. To admit such 
persons to this hospital is to force them into contact with the 
most contagious forms of the disease. This exposure frustrates 
every effort of the physician to determine the period of incubation, 
the early history of the disease and the possibilities of cure; for 
it is obvious that such persons may be re-infected just as fast as 
they are cured. 

The food supply at Kakaako is both abundant and regular ; 
but it is scarcely expected that whites and foreigners will be 
satisfied with poi. There is, however, no provision for the prepara- 
tion of medical comforts, which are now supplied by nursing Sis- 
ters from their own kitchen, and at their own expense. It is 
extraordinary to notice the absence of proper surgical instruments 
and appliances. On the occasion of my visit it w^as found neces- 
sary that a large abcess should be opened, and it was painful to 
observe that the instrument used by Dr. Fitch was taken from 
a post-mortem case, and that it cut through the tissues with great 
difficulty. 

The nursing Sisters bear thrilling testimony to the amiable 
characteristics of the patients, by whom their services are highly 
appreciated. They althogether refute the opinion that the natives 
universally prefer the native kahuna, or that they neglect or refuse 
to take the medicines prescribed for them. They state emphatically 
that the natives appreciate the services of kind and attentive doctors 
and nurses; that they take their medicines willingly, and even ask 
for them when, by accident, they have been omitted. 

In conclusion, I am of opinion that the hospital at Kakaako 
is totally unfit for the treatment of lepers. Under no circum- 
stances does it seem possible to secure complete isolation ; the loca- 
tion is too near the city. The area is too small for the detention 
of many patients, and there is no possibility of instituting any classifi- 
cation of disease. 

MOLOKAI. 

I arrived at Molokai on Tuesday, March 5th, in company 
with Dr. Fitch and Dr. Arning. From information received from 



316 THE PATH OF THE DESTROY ER 

Mr. Meyer, there were 445 males and 300 females, resident on the 
Settlement; of these 62 were in the hospital. With the kokuas 
and their children, the total population of the settlement numbers 
about 1000 persons. 

In company with Dr. Fitch, who evinced the strongest desire 
to afford the fullest information, and under the guidance of the 
Rev. Damien, we visited many of the cottages occupied by the ko- 
kuas and kamaainas, I was most gratified at. the cheerful and con- 
tented population, the entire absence of grumbling or complaint, 
the cleanliness of their persons and the comfort and tidiness of 
all their dwellings, the many neat little plots of onions, sweet 
potatoes, tobacco and flowers in front of many of their houses and 
above all, the general possession of a horse and little articles of 
personal adornment ; everywhere we saw the appearance of hap- 
piness and freedom. All this contrasted most favorably with the 
confinement at Kakaako, and it is impossible to doubt that the loca- 
tion is admirably adapted to rob isolation of its greatest terrors. 
The natural beauty of the scenery; the luxuriance of the vegeta- 
tion ; the richness of the soil ; the necessity of riding to the store 
for beef, poi, oil and other necessaries, encourages movement in 
the open air; and there is no doubt that the lives of many lepers 
have been prolonged, and their sufferings lessened, by the favorable 
conditions under which they live. 

Nor can it be ignored that the government has done much 
towards this result. In the place of the wretched grass huts, 
resting on the damp ground, they have erected many comfortable 
dwellings of wood. They have brought in water from a neighbor- 
ing stream; they have erected a hospital and the residence for a 
physician. They have encouraged those who have the means to 
build dwellings of a better class, and by allowing kokuas they have 
greatly reduced the immorality which naturally resulted from 
separating 200 women from their husbands and forcing them to 
live in the same settlement with 300 men, also separated from their 
wives, neither being in any way deprived of their natural desires, 
and none imbued with any exalted notions of morality. 

But here my commendations end, all the natural advantages 
of Molokai have been destroyed by defective and incomplete ad- 
ministration. The excessive mortality alone condemns the manage- 
ment. During the year 1883, there were no less than 150 deaths, 
a mortality of 150 per thousand annually and during the present 
year, the death rate has risen to 25 per cent, per annum or more 
than ten times that of any ordinary community of an unhealthy 



THE PATH OF THE DESTROYER 317 

type. This high mortality has not been caused by leprosy, but by 
dysentery, a disease not caused by any local insanitary conditions, 
but by gross neglect. The leper cannot stand up against starvation. 
He requires generous food, and he dies without it is supplied. On 
paper and by the regulations he is allowed one pound of beef daily. 
How much does he get? It is not difficult to know. To supply 
those who are entitled to beef rations takes 5,600 lbs. per week, 
and from the beginning of the year the following figures show what 
they really got: 

Pounds Deficiency 

January 2 to January 9, 1523 pounds 4077 

January 9 to January 16, 5811 pounds 

January 16 to January 23, 5600 

January 23 to January 30, 4931 pounds 669 

January 30 to February 6, 5600 

February 6 to February 13, 5600 

February 13 to February 20, 5720 pounds 

February 20 to February 27, 620 pounds 4980 

February 27 to March 6, 5890 pounds 

Deficiency in nine w T eeks 26,526 

So for three w T eeks out of nine there was no beef at all, and 
for two other weeks there was only a very partial supply, and that 
probably consumed by officials, whilst for three weeks only was 
the supply sufficient. During these times, the lepers were given 
salt salmon in lieu of beef, a food which has been universally con- 
demned by the best medical authorities as entirely unfit for the use 
of lepers. 

Nor was the supply of poi much better. The only complaint 
made to me by any leper on the Settlement was on this account. 
For some time past, the supply of paiai has been irregular and much 
had to be baked over again to make it eatable. At the time of 
our visit to the hospital no fresh paiai had been received for a week, 
and none had arrived before our departure, two days afterwards. 
It was said the persons who supply the Settlement had not been 
paid, and that thev refused to supply more until accounts were set- 
tled. 

I inspected many bundles of paiai which had been submitted to 
the oven in order to make them eatable, and I cannot doubt that 
the dietary of spoiled poi and salmon is the cause of the dysentery 
which so generally prevails. 

It was my fortune to see the arrival of a cargo of lepers, and 



318 THE PATH OF THE DESTROY ER 

here also there was the same absence of proper management; no 
preparations had been made for their reception. They were simply 
"dumped" upon the "shore," and left to "shift" for themselves. 
Some of the young had happily been provided by the Sisters at 
Kakaako with a letter to Father Damien, soliciting his interest in 
their welfare. But the rest, if not too feeble to Walk, were left 
to shift for themselves, while a few of the most feeble were con- 
veyed to the hospital. Only that the natives are a kindly and 
hospitable and a long-suffering race, this total absence of prepara- 
tion would be an intolerable evil. 

It is impossible to avoid the comparison between the care be- 
stowed upon Kakaako, and the neglect of Molokai. Whilst the 
former is regularly supplied with food, the latter is starved for 
want of the money which has been appropriated, but is not forth- 
coming for the first necessaries of life. At Kakaako the leper is 
allowed the society of friends and relatives, and isolation is a sham. 
Indeed, it is no wonder that the patients prefer the city life to 
the den of death which has been made for them at Molokai. 

It is evident that if the principle of segregation is to be equally, 
justly, and kindly carried out, and the public properly protected 
against the contagion of leprosy, Molokai is the most fitting lo- 
cality where alone such segregation can be made effectual, and 
where the necessary terrors of confinement might be reduced to a 
minimum. If the money spent at Kakaako, and the care bestowed 
upon its management had been spent at Molokai — if the patients 
at Kakaako had been starved to death, imprisoned, and neglected, 
like those at Molokai — it is possible that the inmates, instead of 
resisting removal, would have prayed to go away. But the absence 
of proper administration appears at other points. I saw two men 
accused of robbery who have been confined in prison for upwards 
of three months without being brought to trial. They were con- 
fined in one cell eight feet by five feet in size, and about ten feet 
high. Their cell is ventilated by a barred opening over the door 
twenty inches by ten inches. Both men are lepers, and as the 
door opened the foulness of the air was evident. These men have 
been advised to confess, and restore the stolen property, when they 
will be given liberty. After our visit, they endeavored to impli- 
cate another party. But this sort of trial by fortune merely indi- 
cates the necessity of police and the appointment of some person 
competent to act as a justice of the peace. 

To conclude, it is to be observed that this same neglect hangs 
over improvements admitted to be essential to the well-being of 



THE PATH OF THE DESTROYER 319 

the Settlement. A further water supply is necessary; $10,000 
was appropriated for the purpose, and nothing has been done. The 
landing places are always dangerous, and sometimes useless. Steam- 
ers conveying passengers and supplies have remained at anchor, and 
have been obliged to return to Honolulu without discharging cargo. 
This might happen whilst the lepers were absolutely in want of 
necessaries, and yet appropriations have been made without result. 
The approach by the pali is also in a shameful state; cattle are 
continually killed upon it. No such difficult pass is necessary to 
confine the leper, and to prevent communication; and it seems 
monstrous that this dangerous path is not improved. 

It is by good sanitary organization, and better sanitary ad- 
ministration, that we raise the standard of public health, and en- 
able the people to resist and throw off the beginnings of disease. 
Then by such means we may hope that the germs of leprosy will 
fall harmless in our midst, and the necessity for leper settlements 
shall cease. 

Your very obedient servant, 

(Signed) J. H. STALLARD, M. B. L. 

Member of the College of Physicians, England, et£. 



REPORT OF DR. EDWARD ARNING 



Honolulu, H. L, November 14th, 1885. 

To His Excellency W. M. Gibson, 

President, and Members of the Board of Health. 

Sirs: — At the request of the president of the Board, I furnish 
you with a report as to the course of investigation carried on by 
me with regard to leprosy. 

The general headings, under which the work is being con- 
ducted, may be classified thus: 

I. Clinical. 

II. Morbid — Anatomical. 

III. Special Bacterial Research. 

IV. Therapeutic. 
V. Hygienic. 

All these different classes of work have had an even amount 
of attention bestowed on them, which I will try to outline in the 
following, without of course going into details, which have found, 
and will find, their place in medical publications. 

I. The clinical work embraces : Inquiry into the general 
historical features of the disease, and into the history of the disease 
in the individual. I have here encountered great difficulties, and 
am afraid have wasted time and patience in trying to derive re- 
liable information from the Hawaiians. Lack of observation of 
their personal health and wilful deceit are so mingled with truth 
in their statements, that I defy anybody to collect reliable statistics, 
such on which it might be possible to base proofs for hereditary or 
congenital transmission of leprosy on these islands. Of course, I 
do not deny that good anamneses may be obtained in some cases, 
but to base theories on this kind of evidence alone must assuredly 
lead to fallacy. 

The second part of the clinical work pertains to the symptoms 
of leprosy, as we find them on these islands, and their similarity, 
or dissimilarity, to the symptoms described in the accounts of 
observers at other times, and in other localities. The practical 
drift of this comparative symptomology, as I may term it, is 
perhaps, not quite obvious, although none the less important. All 
endemic and epidemic diseases are apt to modify their character 
and appearance with time and circumstance. General experience 



THE PATH OF THE DESTROYER 32 J 

goes to show that milder forms follow the more malignant type, 
and may be welcomed as indications that the disease has reached 
its acme. Certainly this applies more strictly to epidemics of 
acute character, but due allowance being given for time, it holds 
good also for the chronic infectious type of disease. 

Now, there seems to me to be no doubt that a great number 
of cases are to be found on these islands which present, and often 
have presented for years, one or two symptoms of leprosy, mostly 
belonging to the group of leprous nerve lesions. I style these 
cases abortive leprosy, and I venture to hope that they may be 
hailed as signs of a decrease of virulence of the disease in general. 
I have bestowed particular attention on the symptoms of these 
initial and abortive cases, as the diagnosis of leprosy is, of course, 
a terribly severe one, and more liable to be disputed in these cases 
than in the advanced stages. Full notes have been taken of all 
these cases, and will be of importance in a number of years hence, 
when I shall try to gain new information about them, and see 
whether the leprous virus was only dormant in them, or actually 
exhausted. Of the value of these cases for therapeutic action, 1 
shall have to say more hereafter. 

A great number of lepers were examined as to the presence 
or absence of the bacillus leprae. The results I summarize as 
follows : 

1. The bacillus is found plentifully in all nodules of the 
tubercular cases, and likewise in the diffused swellings of the skin 
in the tubercular cases. 

2. It is found in similar quantity in the nodules and diffused 
infiltrations of the mucous membranes of the mouth, throat, nose, 
rectum and large intestine. 

3. In case of softening and breaking down of these nodules, 
the bacillus is mixed with the discharge in great quantities. The 
presence of sores in the mouth, throat, and nose causes large num- 
bers of bacilli to be contained in the saliva, and the mucous dis- 
charge from the nose. In leprous diarrhoea which closely simulates 
dysentery, but which I have been able to trace to leprous, not 
dysenteric ulcerations of the bowels, I have been able to detect the 
bacillus in the faeces. 

4. In the so-called anaesthetic cases, the bacillus is not found 
in the anaesthetic patches, nor in the chronic sores of necrotic parts 
of skin, tissue, and bone; but as nerve excisions have proved to me, 
in the nerves supplying these multilated parts with vitality. 

5. The bacillus cannot be found in the bright red patches, 
so frequently ushering in the first formidable attack of the disease 



322 THE PATH OF THE DESTROY ER 

and mostly occurring on the face. These patches are always located 
in the distribution of some larger nerve and are seats of local 
vasomotoric congestion, based on leprous disease of this nerve. 

6. The bacillus cannot be found in the urine of lepers, which 
is accredited by the Chinese to be the infection-carrier "par ex- 
cellence." 

7. The bacillus as such cannot be found in the blood, not 
even during the febrile attacks marking the progress of the disease. 
As it has of late been asserted by different observers that the blood 
contains the germ, particular care has been bestowed on this point. 
Their statement must be due to the fact that in obtaining a drop 
of blood for examination, the bacilli have got into the blood by 
not carefully selecting a healthy spot of the skin in pricking for 
blood, but going through diseased tissue and getting some of the 
bacilli contained in this tissue mixed with the blood. 

For all that, the germ may be contained in the blood, more 
especially during the febrile attacks, possibly in some hitherto un- 
known, but suspected form of spore-condition, a stage of the life 
of a bacillus. These suspected spores may not be visible either 
on account of their minuteness or which is more likely, on account 
of our inability to make them visible by the staining methods we 
use in searching for bacteria. 

As this is a most important point for the whole question of 
the spread of the germ, I have applied myself most assiduously to 
its investigation by devising new staining methods and employing 
the highest magnifying powers at our command, also by culture 
experments with blood taken from lepers during their febrile at- 
tacks, with the idea of making the spores which I consider it likely 
to contain, grow into fully developed bacilli and become visible 
as such. 

At present I must confine myself to the statement that the 
blood of lepers, if taken with all due precautions, does not contain 
the bacillus. 

It has been noted before by Danielssen and Boeck, the Nor- 
wegian observers, that leprous ulcerations of the nose occur in 
anaesthetic cases, which otherwise present no ulcerations. I have 
met with this peculiar condition in two cases. One that of a 
Portuguese who had brought the disease with him from the Azores, 
and the other that of a young Hawaiian girl. These cases being 
otherwise not very advanced, and decidedly not repulsive looking, 
were discharged from the branch hospital. But I must consider 
these cases a great deal more dangerous than their general appear- 



THE PATH OF THE DESTROYER 323 

ance would lead to believe. I was surprised to find in both cases 
the discharge from the nasal sores full of the bacillus. 

Next to this microscopical work in relation to the clinical 
aspect of leprosy, my attention was directed to the peculiar features 
of leprous anaesthesia and paralysis. They have been examined 
under the heads of distribution, intensity, and mode of progress, 
and as to their spinal or peripheral origin. For these particulars 
we have to rely mainly on the modern teachings of electro-diagnosis. 
Let it suffice to say here, that I consider all these troubles due to 
leprous disease of peripheral nerves, and that I believe the dis- 
tinctions found in this respect between leprosy and the great num- 
ber of other diseases of the nerves, spinal cord and brain, will 
enable us to pronounce with more confidence on the nature of 
what it is here customary to call suspicious cases. 

The different appearances of muscular wasting and contraction 
have been studied in comparison to similar symptoms of other 
neurotic diseases. The advanced, or I may say, completed stage 
of this muscular derangement is not so very far different from 
similar troubles due to other nervous lesions, such as rheumatic, 
diptheritic, traumatic, etc., whereas the beginning presents more 
salient features, which will with due regard to accompanying 
symptoms enable us to specify the particular disease as leprous or 
not. 

But this muscular crippling being largely due to mechanical 
causes, is decidedly not as characteristic as the bone disease of 
leprous origin. The mode of attack, the privileged seats of caries 
and necrosis, and the resulting crippling, are decidedly one of the 
most peculiar features of leprosy, and most strikingly different from 
bone disease, due to osteomyelitis of syphilis and tuberculosis. As 
such, they claim a particular share of our attention, more than they 
have hitherto found. 

A large number of photographs and plaster casts have been 
taken of cases, selected at Kakaako and the Molokai Settlement to 
substantiate these experiences, and to serve as illustrations for future 
publications. 

A certain amount of attention and study have, furthermore, been 
accorded to diseases of more external nature, presenting any re- 
semblance to leprous lesions, and occurring both independently and 
in company with leprosy. As such, I mention pigmentary and 
parasitic skin diseases. A very troublesome affliction of this nature, 
unknown to the Hawaiians, has been introduced by the Gilbert 
Islanders, among whom it is quite common. I have seen a pure 



324 THE PATH OF THE DESTROYER 

Hawaiian, who is married to a Gilbert Island woman suffering with 
it. He had been subject to it for years, and was looked upon by 
some as a suspicious case of leprosy, but I have since been able to 
cure him entirely with simple applications of chrysophanic acid. 
The true scabies, or itch, due to the insect "Scarcoptes Hominis,'' 
is exceedingly prevalent at Molokai, and will be hard to eradicate 
there under existing conditions, just, as we are not table to eradi- 
cate it in large cities. I have successfully stamped out a small epi- 
demic of it at Kakaako, and great watchfulness will be further 
needed. Only quite recently a hideous looking case of tubercular 
leprosy, in a seven-year-old boy, was brought to the branch hospital. 
A great part of his hideousness was due to inveterate itch, and this 
trouble caused him a great deal more pain and discomfiture than 
his leprosy. It was, of course, easily cured, and had to be done at 
once on account of its eminent, contagiousness. 

In the foregoing I have attempted to outline the clinical part 
of my work. In case the Board desires it, I will condense the 
results into the form of a schedule, which may serve as a guide 
for examination of doubtful cases. 

II. Morbid — Anatomical Work. Here I can confine myself 
to closer limits. I have been able to make seventeen post-mortems 
of lepers, which have given me much vaulable opportunity to study 
the anatomy of the disease, and have enabled me to make some 
important discoveries regarding the diffusion of leprosy through 
the internal organs. For this reason I deeply deplore that lack 
of support by the Board has put a stop to this most intrinsic part 
of my work since last spring. 

In all advanced tubercular cases, I was struck with the ex- 
treme frequency of grave changes in the larger viscera, more es- 
pecially the lungs, liver, spleen, and bowels. These organs pre- 
sented an aspect quite new to me, and closer examination of their 
tissues has enabled me to prove that we have been mistaken in 
attributing deaths to lepers to inter-current pneumonia, tubercular 
phthisis and dysentery, which were stimulated by the clinical symp- 
toms. The ulcerations of the bowels and the breaking down of 
lung tissue are due to leprous infiltrations, and we shall have to 
modify our opinions of leprosy, being mainly, a disease of the cutis 
and peripheral nerves and introduce terms such as phthisis leprosa 
and enteritis leprosa, etc. 

As far as the brain or spinal cord were examined, I found 
them unaffected, but they will yet have to find a very close and 
searching microscopical scrutiny. This applies generally to all the 



THE PATH OF THE DESTROYER 325 

material collected from the post-mortems and preserved in different 
ways. 

III. The bacterial research, i. e., the question of etiology of 
leprosy, is another essential part of my investigation, and at the 
same time the most subtle and delicate. No one who has not tried 
himself at this particular kind of modern research is able to judge 
of its many disappointments, its dependency upon apparently insig- 
nificant particulars, and the difficulties which crowd upon you 
when you are working outside of the accustomed laboratory with its 
always handy intelligent help and never-failing supply of requisites. 

The outline of experiments embraces: 

1. Search for the germ of leprosy in the air, water, and food. 

2. Attempts to breed it outside of the living organism on 
artificial soils, employing the greatest variety of composition of soil 
and different, grades of constant temperature. 

Of soils I have used : 

1. Koch's meat-peptone-gelatines of varying strengths. 

2. Gelatines made of seaweed and meat. 

3. Gelatines made of seaweed and fish. 

4. Bouillons of meat and fish. 

5. Sterilized and solidified serum of blood taken direct from 
the carotid artery of bullocks and sheep. 

6. Vegetables, solid and in decoctions. 

7. Poi. 

After being sterilized, i. e., freed by high temperature (steam 
and dry heat), from any germs they may accidentally contain, these 
soils are implanted in sterilized containers with the leprous germ 
and kept for weeks together at constant temperature in the incu- 
bator, and carefully watched day by day. 

Until now, the results of this work are altogether negative. 
Under all the varied conditions, I have not once succeeded in ob- 
taining an independent and pure growth of the bacillus leprae. 

Parallel with these culture experiments on artificial soils, a 
large number of experiments were conducted to grow the germ 
in living tissue. For this purpose I have procured and inoculated a 
variety of animals at ages ranging from a few days old to grown- 
up beasts, rabbits, guinea-pigs, rats, hogs, pigeons, and a monkey. 
They were inoculated in and under the skin, in the cavity of the 
abdomen, under the conjunctiva of the eye, in the anterior chamber 
of the eye, and in the ulnar nerve, mostly with small pieces of 
leprous tubercule excised under antiseptic precautions. 



326 THE PATH OF THE DESTROYER 

I have been able to follow up, microscopically, the presence of 
the bacillus leprae at the spot of inoculation for months after the 
inoculation, but have not in a single instance been able to observe 
any general symptom of leprosy. 

The negative results of all this work are not valueless and 
discouraging. On the contrary, they act as a stimulus for further 
research. I am not in the habit of drawing hasty conclusions, es- 
pecially from negative evidence, but as from well proven analogy 
with kindred diseases we know that the bacillus leprae is the 
etiological factor of the malady, and as we find it impossible to 
discover or grow this bacillus outside of the human body, but find 
it in immense numbers and rapidly increasing in the human body, 
we are naturally driven to the following conclusions: 

1. The bacillus leprae is a parasite limited to the human race. 

2. It must be transmitted either directly from individual to 
individual; or 

3. Run through a stage of intermediate life (spore condition) 
which we are at present unable to detect, for reasons given above, 
but which may be present in the soil, water or food, but can only 
get into them from the diseased tissues of a leper. 

4. Accepting either theory, the direct or indirect transmission, 
we must look upon every individual leper, whether in the incipient 
or advanced stage of the disease, as a dangerous focus of the mal- 
ady; he multiplying and nursing the germ in his tissues. 

5. As every seed requires its peculiar conditions of soil, at- 
mosphere, etc., to allow it to strike, and, when struck, to grow 
up to be itself a seed-bearing plant, so does the leprous germ re- 
quire a certain disposition of the human soil to strike and thrive. 
What this peculiar disposition may be, we are at present unable 
to say. It is evidently a disposition which may coexist with appar- 
ent good health, as many examples of strong, rubust men, develop- 
ing leprosy, show us. This disposition may possibly be transmitted 
by heredity. I desire not to be misunderstood on this particular 
point. I do not believe that leprosy itself is in any case con- 
genital ; but I do believe that a certain weakness to resist its attacks 
may be transmitted. 

I have hinted at. similar ideas in the motives accompanying 
my application to His Majesty's privy council, to be allowed to 
perform some inoculation experiments on the condemned convict 
Keanu. The application I made resulted in the sentence of death 
passed on the murderer, being commuted to penal servitude for life. 
With the prisoner's written permission, I commenced operations on 



THE PATH OF THE DESTROYER 327 

the last day of September, 1884, after having previously made a 
most searching inquiry as to any leprous taint in his family, and a 
close examination of his own body. This examination satisfied 
me that, as far as I am able to judge, no trace of the disease could 
be found in him at the time. A further step was to insure that 
the prisoner would not be employed at work outside of the prison 
walls. 

As stated above, I inoculated Keanu on the 30th day of 
September, 1884, and for the four weeks following, I saw him 
daily, and after that once a week for several months, a microscopic 
examination of the inoculation spot being made every time. After 
that period the convict has been examined by me regularly once 
or twice a month. The microscope revealed the presence of the 
bacillus leprae in large numbers until the middle of March, 1885. 
They have since gradually diminished in number, but a recent 
excision of a small part of the scar shows them present even yet, 
i. e., nearly fourteen months after the inoculation. 

At the same time there is nothing in the general appearance 
of the convict which would denote any development of leprosy. 
Pains in the joints of the inoculated arm, from which Keanu suf- 
fered in January and February last, have since disappeared. 

To the foregoing I wish to add the following remarks: 

1. I do not consider my experiment with Keanu concluded, or 
mature for scientific publication. 

2. Even if future observation should show us no trace of 
leprosy developing, we should not be able to infer more from the 
experiment than that in this case inoculation proved ineffectual. 

3. I have given this account of the experiment to Your Excel- 
lency and the members of the Board, to allow you to judge of 
the spirit in which it is being conducted. 

4. Moreover, I have been induced to do so by recent per- 
fectly unauthorized publications of Dr. Fitch, in a California 
medical journal, as a protest against the thoroughly unprofessional 
conduct with which this author, who could only gain knowledge 
of my doings in an under-hand manner, has brought my name and 
work forward in support of his own unproven assertions. 

I take the same opportunity to protest against the narrow 
arguments used by the same author, as far as this subject of in- 
oculation goes. He cites my name, and an ordinary post-mortem 
blood poisoning which I acquired at the autopsy of a leper as a 
proof of the non-possibility of inoculation of leprosy. It would 
be a very bad thing, indeed, if all the cases of common, local, or 




CHARLES R. BISHOP. 

Banker, capitalist, philanthropist. * Ninety-three years old January 25, 
1915. Founder of the Bishop Home for leper girls at Kalaupapa, Molokai, 
and good friend and generous benefactor to the Hawaiian race. 

Husband of the late Chiefess Bernice Pauahi, the foundress of the 
Kamehameha Schools for Hawaiian boys and girls — the foremost and best 
educational institutions in the Pacific Ocean. 

The contiguous Bishop Museum, with its masterly arranged exhibits, 
affords unrivalled facilities for study amongst its unique and splendid 
collection of Polynesian antiquities, etc. 

* Died at San Francisco, California, June 7, 1915. 



THE PATH OF THE DESTROYER 329 

general septic poisoning at a post-mortem should result in our ac- 
quiring the disease the patient was subject to. 

Vague statements of this nature do not deserve, and would 
not find an answer from me in a scientific publication, but as they 
are put forward with the intention of captivating the mind of the 
general public, and are, as bold and positive assertions, more apt to 
do so than the often restricted and guarded utterances of calm 
independent observation, I have given them this brief consideration 
in my report. 

Closely allied to the inoculation question is the subject of 
vaccination. Your are doubtlessly aware of the very prevalent 
opinion among medical men, that the unusually rapid spread of the 
disease may possibly be attributed to the great amount of indis- 
criminate vaccination which has been carried on in these islands. 
There have, if my information is correct, unquestionably new cen- 
ters of leprosy developed after vaccination was practiced, and 
several old inhabitants have told me how they themselves used no 
precautions whatever in vaccinating during a small-pox scare, but 
brought the lymph directly from one arm to another, without even 
wiping either points or lancet. 

To bring some light on this moot point, I vaccinated a num- 
ber of lepers. The vaccination only took in three cases, one tuber- 
cular and two anaesthetic. Both the lymph and crust of the 
tubercular case contained the bacillus leprae ; in the anaesthetic 
cases I could not detect it. As the vaccinations are now conducted 
by medical men and with bovine virus, it may seem to be per- 
fectly superfluous to dwell any further on this point, it apparently 
presenting only historical interest. But recent experience causes 
me to advise the Board not only to supply its medical officers with 
animal vaccine and points, but also to issue strict regulations as 
to the manner how this virus is to be used. If the lancet is dipped 
into the virus, then into the arm, then again into the virus and 
the next arm, or if points used for one vaccination are re-coated 
for further use, as physicians of the other islands have, at my special 
inquiry, owned to doing, then the use of bovine virus gives us no 
safeguard whatever against the propagation of constitutional dis- 
ease by vaccination. The main point is the thorough disinfection 
of the lancet after making one vaccination, and before dipping it 
into the lymph for the next arm. This is easily obtained by heat- 
the point of the lancet in a spirit flame to a dull red heat, and it 
forms a main part of the instructions issued to the government 
physicians in Germany. 



330 THE PATH OF THE DESTROY ER 

Another point which has been raised is the possibility of the 
leprous virus being conveyed by mosquitoes. I am at present oc- 
cupied with investigating this subject. The endemic elephantiasis of 
the tropics, a disease which is happily unknown here, has lately 
been traced to propagation by mosquitoes, and by these solely. 

IV. The next of my headings is that relating to therapeutics. 
As this is one of the practical sides of the question, and one in 
which the general public naturally takes the greatest, interest, as it 
considers it more within its scope than the rather distant etiological 
and pathological studies relating to leprosy, I beg to be permitted 
to begin with some general remarks on this subject. 

All our therapeutic action may be classed either as specific or 
symptomatic. Looking upon disease as a weed which grows in the 
fertile soil of the body, we may say that with the former we aim 
to strike at the root of the weed, whilst with the latter we only 
lop its branches and keep its growth in check. 

There are very few diseases where we can rely entirely on 
specific treatment, the most notable being syphilis, malaria and 
acute rheumatic fever. For these three diseases we possess in 
mercury and iodine, quinine and salicylic acid respectively, real 
specific medicines; and if by their aid we have been able to restore 
a patient suffering from any of these troubles, we may say he 
has been cured by these medicines. On the other hand, we have 
a vast number of diseases where we have to rely on symptomatic 
treatment, i. e., mainly alleviate pain, ward off external danger and 
keep up the power of the body, so that it may rally to healthy re- 
action and cast off the disease by its own efforts. This applies to all 
our acute zymotic diseases, the eruptive fevers, small-pox, scarlatina, 
measles, etc., to the various typhus fevers, to cholera, dysentery, etc., 
and very nearly to all chronic diseases, foremost to consumption, 
the scourge of our age, and as yet to leprosy. 

We have no specific for leprosy, nor has any man of any 
other country or nationality. Scientific medical information reaches 
too far now-a-days to permit of any agent of this kind being known 
by an individual and kept as a secret. Anything put forward in 
that way without being published through the regular channels must 
be regarded as quackery and nothing else. 

Anybody who is read on the subject of leprosy, in fact, any 
remoter medical literature, will be struck with the amount of at- 
tention bestowed on the therapeutic portion in those writings. The 
tendency of our age is to simplify therapeutic action as much as 
possible, and not experiment empirically, but bring therapeutics 



THE PATH OF THE DESTROY ER 331 

within the rational limits of physiology, etiology and pathology. 
There is scarcely a drug in the pharmocopeia, at least scarcely a 
class of drugs, that has not been most systematically tried in the 
treatment of leprosy. Over and over again men of sanguine views 
have found what they called a specific cure, but in every instance 
calm and unbiased judgment has afterwards pronounced a verdict 
of uselessness. 

How is it that these facts are not accepted, and a different 
line of therapeutic attack inaugurated? 

Let us pay more attention to careful symptomatic treatment 
of leprosy. Even the advanced cases we can help and benefit a 
great deal more than is generally believed. The great number of 
incipient cases will furnish us opportunities enough to try new 
lines of specific treatment. 

Let the scourge this nation is subject to be turned into as 
much good as possible, and let arrangements be made (for it is 
not feasible, under the present circumstances) to let at least a 
limited number of advanced patients be benefited by modern medi- 
cal and surgical progress. On the other side, let the incipient cases 
be divided into classes, and treated systematically on different prin- 
ciples, but under one general management and observation. 

I beg to refer you to my first report, written for the session 
of the Legislature of 1884. I have already then dwelt on this 
point, and, I am happy to say, not without results. My sugges- 
tions of a home for suspected and incipient cases, and of regular 
medical school examinations, have been carried out, and order and 
cleanliness prevails, where there was an acknowledged bad state 
of affairs before 1884. But if you ask me whether enough has 
been done to be able to say to the world that all is being done 
for the lepers that can be expected, and in a model w T ay for other 
nations, looking with fervent interest to Hawaii's fight with lep- 
rosy, I must say no. The therapeutic side, the treatment is neg- 
lected. 

I have been told that my views are too advanced. I answer 
that I am proud of it, and that I consider nothing can be too 
advanced in the treatment of a question, which has been grappled 
with for centuries in the old style of isolation and feeding. 

What I have repeatedly applied for is a small hospital-ward 
within the Kakaako enclosure, with, say, no more than six or ten 
beds, but managed separately from the general Settlement. This 
hospital should have a nurse and a servant attached to it, and to 
it exclusively; have arrangements for hot and cold and permanent 
baths, steam baths, gas baths, etc., and ought to be fitted with all 



332 THE PATH OF THE DESTROYER 

the necessaries of clinical research, and medical, surgical and electri- 
cal treatment. The patients .would be selected from the general 
flock, according to the wishes of the physician put in charge of this 
trial station. Then the journals, which would have to be strictly 
kept of every case, would be able to contain all that accurate 
information, without which modern clinical work is considered in- 
complete, and which it is impossible to gain under existing cir- 
cumstances. Then electrical treatment, which is undoubtedly of 
great, even surprising benefit, could be carried on; and surgical 
operations, such as removal of necrosed bone, stretching of nerves, 
cutting and stretching of contracted muscles and sinews, and oper- 
ations on the eye and other important organs, be attempted with 
more view to success than is possible at present, where no arrange- 
ments of any kind are made for all this at the branch hospital. 

The therapeutic results I have achieved, under less favorable 
circumstances than those enumerated did offer, urge me to renew 
this request. 

After these general remarks I will, in a cursory way, state the 
methods of treatment I have adopted for different classes of lepers, 
native and foreign, some treated at Kakaako, some as outside 
patients. Some sixty cases I find in my private books, which I 
look upon as either fully developed and progressive, or abortive, or 
incipient, or suspicious cases of leprosy. A number of them have 
since been received at the branch hospital, a number of foreigners 
have left the country, others I have lost sight of, and some few I 
consider so far benefited by continuous treatment, that I might 
doubt their being afflicted, if I did not. find the record of their 
previous state in my books. 

Since about a year, I have found in the external use of sal- 
icylic and pyrogallic acid agents of undoubted value for symptomatic 
local treatment. With them it is possible to destroy leprous tuber- 
cules and soften diffused leprous infiltrations, sometimes even to 
restore a portion of the feeling lost over these infiltrated patches. 
Especially the conspicuous red patches, which usher in the com- 
mencement of tubercular leprosy, and often stand for years with- 
out fading, subside readily under local treatment with an ointment 
or paste containing ten per cent of salicylic acid. Isolated tubercles 
and serpiginous leprous papules have been entirely removed with a 
strong solution of pyrogallic acid in traumaticine, or with a ten 
per cent pyrogallic acid ointment. For the diffused leprous in- 
filtrations I use a ten per cent solution of salicylic acid in oleic acid. 
Internally I have used either nothing, so as to be sure that the 



THE PATH OF THE DESTROY ER 333 

disappearance of the symptoms was due to the local applications 
alone, or salicylic acid in large continued doses. I have certainly 
seen fresh febrile eruptions occurring during this treatment, but in 
several cases a decided improvement, even when used without any 
local treatment. 

Special reasons induced me to try a very active sulphur treat- 
ment in one case. Sulphur was administered internally as hypo- 
sulphate of soda, and the patient was subjected to a sulphurous acid 
gas bath every day for one hour. The more pronounced tubercles 
of the face were at the same time treated with compression and 
deep local injections of absolute alcohol, which caused prompt break- 
ing down and cicatrization of the tubercles. This method I have 
since discarded for the more efficient and less painful pyrogallic 
acid treatment. I am sorry to say that this patient, whom I had 
under this treatment for a full year, and who was one of those 
put under my special charge by the Board, was, like two other 
patients of this particular lot, removed from the branch hospital 
without my knowledge. Such steps are naturally not inclined to 
promote scientific work. In deciding the advisability of their re- 
moval I might at least have been asked, and my reasons for re- 
taining them weighed with those which prompted the action of the 
Board. 

The much-abused mercurial treatment has been used both as 
a general and local application. For the general treatment I have 
relied chiefly on hypodermic injections of corrosive sublimate, a 
centigramme of the drug being injected daily. In one case of a 
well-educated native man, who has been under my treatment for 
nearly two years, I have given two courses of these injections — 
one of a hundred, and the next of sixty — without any trouble, al- 
though the injections are a little painful. His enlarged ears were 
treated with excisions and deep scarifications, and an anaesthetic 
spot on the back and the anaesthetic big toe of his left foot were 
successfully treated with electricity. The patient now feels that 
he has regained his lost strength and mental activity, looks hale 
and hearty, and would pass very close scrutiny without being con- 
sidered in any way suspicious. For all that I do not for a mo- 
ment pretent to have effected a lasting cure — that remains for 
time to prove — nor do I feel inclined to let the patient go without 
further treatment, though he is apparently in vigorous health. 
He is at regular periods taking small doses of mercurials, and should 
go on with this for a number of years. 

In another case of rapidly progressing mixed form the quick 



334 THE PATH OF THE DESTROYER 

course of the disease has changed to a slow progress after eighty 
hypodermic injections of corrosive sublimate. I am sorry to say 
that this is one of the cases taken out of my observation at the 
branch hospital. The anaesthetic and contracted hand was steadily 
improving when I was treating it electrically at my office. This 
had to be discontinued when the patient was removed to the branch 
hospital, no appliances for this purpose being provided for there. 
Since her dismissal she is under no treatment whatever, but, as I 
hear, in the family-way, and losing the improvement she had 
gained in her hand. 

In other outside cases I have used creosote and carbolic acid 
treatment, the former in pills of which Dr. Hillebrand speaks very 
highly, the latter as hypodermic. Only in one case did I see marked 
effects. In this, local injections of a five per cent carbolic acid 
solution were used, and restored color and feeling in a white an- 
aesthetic spot on the cheek. 

Iodide of potassium failed entirely at my hands. 

Electrical treatment was used in quite a number of anaesthetic 
cases, and when persevered in long enough proved very efficient. 
One patient especially, a white man, who had several anaesthetic 
patches on the arms, has recovered entirely. He has at the same 
time been taking from \y 2 to 3 grammes of salicylate of soda daily 
for a whole year. Another patient, a native woman, who had, be- 
sides other symptoms, a nearly complete anaesthesia of the left arm 
and contracted useless hand for over ten years, is now enabled to 
stretch her fingers and use them for needle work, the feeling being 
completely restored in two of the fingers. The treatment in her 
case has extended over very nearly eighteen months, and very high 
doses of arsenious acid, up to nine centigrammes daily, have been 
taken internally, the patient standing this drug extremely well, 
whilst from some other experiences I have learned to be extremely 
cautions with this drug in the treatment of leprosy. 

The very distressing symptoms of the nose, mouth and throat, 
which are in the general run of the treatment of leprosy all helped 
to a gargle and nothing more, deserve especial attention for several 
reasons : 

1. There is nothing so apt to run down the appetite, and 
with it the general health of the patients, as the continual swallow- 
ing of putrid matter from festering sores of these parts. 

2. The discharge from these sores containing the bacillus in 
great numbers, as stated above, there is sufficient ground to believe 
that like in similar cases of tuberculosis, the leprous ulcerations of 



THE PATH OF THE DESTP OYER 335 

the bowels are caused by self-infection from swallowing the pus 
secreted from these sores. 

3. The heavy breathing and hoarseness, the disgusting smell 
and the ever-abundant secretion makes these patients doubly loath- 
some and dangerous. 

My experience teaches me that these ulcerations are especially 
amenable to local treatment. The daily application of antiseptics, 
caustics, and astringents, as the case may require, the fixing of oint- 
ment tampons, the use of medicated sprays and steam inhalations, 
all this can be used with much success, and ought to be used in a 
hospital for lepers. 

Similar arguments relate to the treatment of the disease of 
the eye so common in leprosy. I firmly believe that early operation 
for leprous nodules on the conjuctiva, and for leprous iritis will 
rescue a large number of the unfortunates from irretrievable blind- 
ness, and the paralytic drooping of the lower eyelid, which so 
commonly leads to loss of vision in leprosy, may just as well be 
benefited by plastic operation as it is in facial paralysis from other 
causes. But to effect all this, and a great deal more which I will 
not detail, there is required good-will on all sides. On part of 
the physician it must be brought, and on part of the patients it 
wall have to be courted and enforced by more vigorous support of 
the medical work by the Hospital Board, working in concord, and 
with the advice of the hospital physician. 

I now draw to the close of this report with a few remarks 
as to 

V. Hygienic Measures. I will skip the commonplace, but 
nevertheless all-important subject of general sanitation and im- 
proving the social habits of the people, but try to give some more 
definite points. 

Traveling around the islands to gain information on these 
subjects, I found in some parts, especially so in parts of Kauai and 
Maui, more lepers at large and in unconstrained intercourse with 
the healthy population than ought to be under the present laws. 
Now, I do not think it possible for the government to take charge 
of all lepers, but as long as the powerful law of segregation is in 
force, let it be brought to bear on such cases which are really com- 
plained of as public nuisances. I have intentionally visited the remot- 
est gulches and corners where few white men penetrate, and have 
found more bad cases of leprosy than I expected. Perhaps it may 
te just as well to leave these poor wretches in their homes, where 
they are just as much or more out of the way than at Kakaako or 



336 THE PATH OF THE DESTROYER 

Kalaupapa; but there is an important point to consider. Pent up 
with these bad cases in their squalid huts and houses are apparently 
healthy children. These ought to be removed, for they are the 
future and hope of the nation. And not alone the girls, but also 
the boys should be removed, especially so as old and new statistics 
point to a prevalence of leprosy among the male sex. 

But one thing must be avoided if we accept the theory of 
disposition in children of leprous parents. We must keep these 
out of harm's way even more carefully than other children whose 
families are free of the taint. 

I know that it is acknowledged by Your Excellency and the 
members of the Board that the present Kapiolani Home is not in 
its proper position, and that only the most pressing circumstances 
have necessitated the selection of the present site. 

From my point of view I must stand by my original proposal 
to have the Home out of sight and reach of the leper asylum. If 
we want to keep the possibly disposed systems of the children free 
from the disease, the first step should be to remove them as far as 
possible from it, and not to tabu them within the walls of a 
lazaretto. 

The next point touches the vaccination question, with which 
I have dealt at length under the heading of experimental work. 
I would further urge that the medical examinations of school chil- 
dren, which has led to the elimination of quite a number of cases, 
should be kept up regularly and carefully. As an instance of their 
necessity, I may quote a case which has quite recently come under 
my observation. A little girl (native) belonging to one of our 
large schools passed my close examination a year and a half ago 
as healthy, but now presents initial symptoms of leprosy. We must 
not rely on general healthy appearance in these examinations, and 
on a furtive glance at hands and arms. I have found unmistakable 
marks of leprosy on the back of a child that held a recent health 
certificate. Moreover, we shall have to extend our examinations 
even to very young children in spite of Dr. Fitch's assertion that 
leprosy does not make its appearance before the period of second 
dentition. I have seen a child with clear signs of leprosy at. 3>]/ 2 
year of age, and know of another boy who was a marked case 
at four years old. 

As this country has to rely on immigration mainly coming 
from countries where leprosy is endemic, i. e., China, the Azores, 
and Japan, considerable care ought to be exercised m guarding 
against new cases of the disease being imported from there. I know 




BERNICE PAUAHI BISHOP. 



High Chiefess or Alii, wife of Charles R. Bishop. 

Born December 19, 1831. Died October 16, 1884. 

FOUNDRESS OF THE KAMEHAMEHA SCHOOLS 



338 THE PATH OF THE DESTROYER 

of two unquestionable cases of leprosy having come here from the 
Azores — the one was the Portuguese man mentioned above, the 
other a young Portuguese girl who, immediately after her arrival, 
half a year before I was asked to examine her, obtained a position 
as nurse in one of our best families. 

Altogether it is deplorable, though perhaps inevitable, that 
these islands with their terrible abundance of leprosy should be 
repopulated by the very nationalities, who seem to have not yet 
overcome a disposition to the disease as much as other races. 

There are two more points I wish to bring again before you, 
one of more local, the other of general and scientific importance. 
Both have been subjects of previous memoranda to the president of 
the Board. 

The first applies to the necessity of furnishing a wash-house 
at the Kakaako hospital to obviate the certainly unpermissible prac- 
tice of some of the lepers sending their soiled clothing out to be 
washed. 

The other relates to the disposal of the dead bodies of lepers. 
To make this report complete, I shall here insert the text of my 
previous communication, sent to the president of the Board in 
June last: 

To His Excellency W. M. Gibson, 

President of the Board of Health. 

Sir: I beg to submit to Your Excellency's consideration the 
following facts, which I have recently discovered with regard to 
the power of resistance of the germs of leprosy to putrefaction. I 
communicate this result of my work immediately to you, because 
it seems to me to have a direct practical bearing towards public 
sanitation. 

A series of experiments in this line were commenced in Oc- 
tober, 1884. Leprous tissue and matter was set aside under con- 
ditions of temperature and moisture most conducive to slow and 
thorough putrefaction, whilst the growth of the larger fungi was 
at the same time carefully excluded. From time to time a micro- 
scopical examination was made, and the characteristic bacillus leprae 
was not only found to hold its own against the germs of dissolution 
and putrefaction of albuminous matter, but met with so abun- 
dantly and laden with spores that the idea suggested itself there 
might be actual increase. An examination made a few days ago of 
the remains of this leprous tissue, set aside fully eight months ago, 
shows it to consist nearly entirely of swarms of the bacillus leprae. 



THE PATH OF THE DESTROYER 339 

closely packed. Every vestige of the cellular and fibrous structure 
of the tissue has disappeared, even the bacteria of putrefaction have 
crumbled up into a mass of detritus, but the bacillus leprae is there 
with all its peculiar microchemical reactions. 

The discovery prompted me to examine dead bodies of lepers 
under the ordinary and natural influence of decomposition. Not 
being able to acquire the desired corpse here, I went to Molokai, 
and succeeded in procuring parts of the body of a tubercular case, 
which had been buried for nearly three months, and was in the 
most active state of putrefaction. After what I had learned from 
my experiments, I was not surprised to find the leprous germ pres- 
ent in large numbers. 

I candidly admit that I am not yet able to give a decisive 
answer to the question, whether these germs are alive and capable 
of reproducing the disease. This final question will not be solved 
until we have been successful in artificially cultivating and in- 
oculating the germ, a result which none of us who are engaged in 
this question, have as yet achieved. However, I feel personally 
confident, from the microscopical evidence alone, that they have 
not lost their power of germinating under the above named con- 
ditions. At any rate, it seems to me desirable to effectually bar 
even the possibility of a spread of the disease, through the slow 
decomposition of the dead bodies of the lepers in the graveyards 
surrounding the town. Cremation would certainly be the surest 
safeguard, but, as that can hardly be achieved, I suggest the com- 
pulsory filling up of the coffins containing the corpses of lepers 
with quicklime. To secure this end, I deem it necessary to stop 
the practice of letting friends and relations take away the dying 
lepers to their homes, as has recently been done in several cases. 

* * * 

Thus far goes my previous communication on this subject. 

Let me close these observations and suggestions relative to 
the hygienic side of the question with the following general appeal. 
Increasing familiarity with a signal danger lessens our fear of it, 
but not the danger. This applies most pointedly to our relations 
with leprosy. We live amongst it, and there are many of us, not 
only Hawaiians but also foreigners, who have grown so accustomed 
to it that they not only do not heed it themselves, but by word 
and deed try to dispel the fears of others. This is all very well, 
and has its good side when it becomes necessary to dissipate a 
scare. But as long as this is absent it will be a good thing to 
sound a warning note from time to time, so that carelessness on 



340 THE PATH OF THE DESTROY ER 

part of the population may not be the outcome of assurances of 
safety. Examples like those of Father Damien, who has now him- 
self become a leper, and as such a veritable martyr to his cause, 
and of other worthy and pure members of the community whose 
names I am not authorized to mention, should teach us a lesson, 
and cause us all to work harmoniously and united for the one 
good end, to confine the dreaded leprosy to its closest limits, and 
to help and support the poor afflicted ones with the best of our 
will and skill. 

I have the honor to remain, 

Yours most respectfully, 

(Signed) ED. ARNING, M. D. 



COPY OF CORRESPONDENCE BETWEEN 

THE BOARD OF HEALTH AND 

DR. EDWARD ARNING. 



Office of the Board of Health, 
Honolulu, Nov. 30, 1885. 



Ed. Arning, M. D. 



Sir: By instruction of His Excellency Mr. Gibson, the presi- 
dent of the Board of Health, I have the honor to acknowledge re- 
ceipt of your report as to the course of investigation carried on by 
you with regard to leprosy, dated Nov. 14, 1885, addressed to him 
and to the members of the Board of Health, and am furthermore 
instructed to make the following remarks for your consideration 
and attention. 

In the month of February of the present year, His Majesty's 
government, through the foreign office, addressed His Majesty's 
accredited representatives abroad, a series of questions somewhat 
similar to those propounded by the Royal College of Physicians of 
London in 1862, to medical representatives of foreign powers in 
whose borders leprosy exists, or is suspected of existing. To these 
questions His Majesty's government has received interesting and 
valuable replies in many instances. It is proposed to print these 
reports in conjunction with your report and other material of 
value in the study of leprosy. His Majesty's government deeply 
appreciating the good-will shown by other nations in collecting and 
forwarding, at no little cost of time, labor and money, the infor- 
mation required, is naturally anxious to reciprocate to the best of 
its ability by furnishing to such foreign powers all the information 
the Board of Health can obtain in regard to leprosy as it exists on 
the Hawaiian Islands. 

It is reasonaly considered that after the two years you have 
spent on these islands in the service of the Board of Health with 
liberal emolument, combined with your high recommendations to 
the Board as an honorable scientist and close and faithful student, 
and the facilities and opportunities it has placed at your disposal 
for experiment and observation, you have been enabled to acquire 
knowledge and information in regard to leprosy of great value and 
importance to the health authorities of the kingdom, and to all 
interested in the study of the disease. The impression is therefore 
felt that it is within your power to present a report of value and 
benefit to those engaged in battling with the disease abroad ; credi- 



342 THE PATH OF THE DESTROYER 

table to this State and honorable to your talent and your position 
as the government's special medical representative. 

I am not instructed to make any comments upon the report 
of Nov. 14th, further than this, that in the opinion of His Ex- 
cellency the president of the Board, it is incomplete and incon- 
clusive, and not such a one as might be anticipated after two years 
of special labor, with considerable outlay of public funds. 

I am instructed to speak of the report as incomplete by reason 
of references in it to notes and data not presented to this honorable 
Board with the report, but mentioned as being retained or intended 
for "future publications;'' and, furthermore, to request that, you 
furnish to the Board by way of schedule or appendix, the schedule 
referred to on page 12 of the report to "serve as a guide for ex- 
amination of doubtful cases." It. is also deemed proper that the 
"full notes," referred to on page 4, should be presented to the 
Board. On page 10 reference is made to photographs and casts 
of cases selected at Kakaako and Molokai, the president expects 
that duplicates of these be placed in possession of the Board — 
allowance being made for any extra expenditure on your part — and, 
also, the notes of autopsies made by you on hospital cases should 
be given for future medical reference. 

On page 32 occurs this: "I will, in a cursory way, state the 
methods of treatment I have adopted for different classes of lepers, 
native and foreign, some treated at Kakaako and some as outside 
patients." The president is of opinion that the notes of such cases 
or some of them would materially add to the scientific value of 
your report abroad, and should be furnished. 

On page 40 reference is made to your "traveling round the 
islands," in search of information, and also to the large numbers 
of lepers on Kauai and Maui, "in unconstrained intercouse with 
the healthy population." 

The president will be pleased to receive more definite infor- 
mation on these matters, for the consideration of the Board. 

A more extended notice of the large body of leper patients 
whom you have visited on Molokai could not fail to be of interest. 

Having outlined the views of His Excellency the president 
for your consideration, 

I have the honor to be, sir, your most obedient servant, 

FRED H. HAYSELDEN, 

Secretary Board of Health. 



THE PATH OF THE DESTROYER 343 

Honolulu, Dec. 15, 1885. 

To His Excellency W. M. Gibson, 

President of the Board of Health. 

Dear Sir: I am in receipt of the letter of the secretary of 
the Board of Health, dated Nov. 30th, and regret that my report 
on the progress of my investigation of leprosy is unsatisfactory to 
Your Excellency. 

I will beg to state, that after due consideration, and after 
having submitted my report to some of my medical friends, viz., 
Doctors Trousseau, McKibbin and Brodie, I cannot modify it or 
make a more extensive one. My friends and myself are of opinion 
that as information for "a lay Board of Health," it is as complete 
and conclusive as necessary. 

It is far from my desire to have, for the present, a full sci- 
entific report published, as my investigations are not nearly com- 
pleted, and will probably take many more years to allow me to 
come to positive conclusions. 

Footing on the preliminary correspondence between Your Ex- 
cellency and Dr. Hillebrand, and our own conversation after my 
arrival, I could not look upon the moderate salary allowed me by 
the Board otherwise than as an assistance and encouragement to 
purely scientific work; but never for a moment understood that 
either my work or notes, or specimens, etc., could be claimed by 
the Board for its own purposes. The above were mostly obtained 
at my private expense and for my private use, and, therefore, I 
must decline to furnish duplicates or put at the disposal of the 
Board my private notes of cases and post-mortems, these being 
collected for future scientific information and publication. 

It is unnecessary to say that in these latter due credit will 
be given to the Hawaiian government for all assistance rendered 
to me. 

I have, however, keenly felt that this assistance was not such 
as I was led to expect from the above-mentioned correspondence, es- 
pecially as far as moral support was concerned. 

I further beg to state that. I did not visit the lepers on the 
other islands with the intention of gathering information for the 
Board of their whereabouts, but for my own private knowledge, 
to be able to judge of the causes of the continued spread of leprosy, 
in spite of segregation. The finding and segregating of these cases 
is a duty devolving on the police and local government physicians. 
I have the honor to remain, yours respectfully, 

ED. ARNING, M. D. 



344 THE PATH OF THE DESTROYER 

Office of the Board of Health, 
Honolulu, Dec. 22, 1885. 

Ed. Arning, M. D., Honolulu. 

Sir: By the instructions of His Excellency the president of 
the Board of Health, I have the honor to inform you, that by a 
recent resolution of the Board, a special committee was appointed 
to make such reduction in the medical staff of the government as 
they deemed advisable; and, acting under this authority, it has been 
decided to discontinue your services on the staff. 

Your statement to the president, in your letter of the 15th 
instant, that it will take you many years to come to positive con- 
clusions in your medical investigations; that you never understood 
that your work, or notes, or specimens could be claimed by the 
Board, and as you decline to furnish duplicates, or place at the 
disposal of the Board any notes of cases or of autopsies — all these 
being collected, as you state, for future scientific information and 
publication — satisfies the Board, after the expenditures made on 
your account, of the propriety of their action in this matter. 

Your appointment as a physician, in the employment of the 
Board, will cease on the 31st instant; and between now and that 
date you will vacate the offices situated in the Kakaako hospital 
enclosure, now used by you, leaving therein such articles as have 
been supplied to you by the Board. 

I have the honor to remain, sir, your most obedient servant, 

FRED H. HAYSELDEN, 

Secretary of the Board of Health. 

* * * 

Honolulu, Dec. 28, 1885. 

Fred H. Hayselden, Esqr., 

Secretary of the Board of Health. 

Sir: I have the honor to acknowledge receipt of your letter 
dated December 22, 1885, informing me of the decision of a special 
committee of the Board of Health to withdraw my appointment as 
a physician in the employment of the Board, by the end of the 
month. 

The premises I have used for my work at Kakaako will be 
vacated by the 31st inst. I shall leave therein such articles as have 
been supplied to me by the Board. 




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346 THE PATH OF THE DESTROYER 

I shall draw my salary of $150 for December, on the 31st inst. 

I furthermore claim the payment of my expenses connected 
with my return to Germany, which His Majesty's government 
agreed to defray, and which I figure at five hundred dollars. 

I have the honor to remain, sir, your most obedient servant, 

ED. ARNING, M. D. 



Copy of correspondence between Hon. C. R. Bishop and others, and 
the president of the Board of Health, in regard to Dr. Ed- 
ward Arning. 

Honolulu, January 28, 1886. 

To His Excellency W. M. Gibson, 

President of the Board of Health. 

Sir: A number of the physicians of Honolulu, and many 
other gentlemen resident here, consider it of very great importance 
that the investigation by Dr. Arning, applying to leprosy, should 
be continued in a thorough manner for a further period of two 
years; and believing that the Board of Health will be not only 
willing, but quite desirous, of co-operating in a work which may 
be of inestimable advantage to this country, and of value to the 
cause of science and humanity the world over, by granting such 
facilities and moral support as are and may be within its power, 
the undersigned, a committee appointed by the subscribers to a 
fund in aid of such investigation, are authorized to assure Your 
Excellency that if such support and facilities as are necessary are 
granted by your Honorable Board for the period above stated, 
the salary of Dr. Arning will be paid from said fund. 

Herewith we enclose copy of a communication, signed by a 
number of the prominent physicians of this city, expressing their 
views upon the matter in question. 

Hoping for an early and favorable reply to the foregoing 
proposition, we have the honor to be, 

Your obedient servants, 

CHAS. R. BISHOP, 

F. A. SCHAEFER, 

J. B. ATHERTON. 



THE PATH OF THE DESTROYER 347 

(COPY) 

To Messrs. C. R. Bishop, F. A. Schaefer, and J. B. Atherton, 

Members of the Committee of the Leprosy Investigation Fund. 

Gentlemen : The undersigned, members of the medical pro- 
fession residing in Honolulu, have learned that it has been decided 
by the Board of Health to discontinue the appointment of Dr. 
Arning as physician in charge of leper patients in the branch hospi- 
tal at Kakaako, and that the reason alleged for such removal is 
the necessity for retrenchment in the expenditure of the Hawaiian 
treasury. 

We consider that it is advisable, for the benefit of natives 
as well as foreigners, that the study of leprosy and the causes 
associating for its spreading should be continued. 

Dr. Arning having come to this country for the express pur- 
pose of investigating in a scientific manner the causes of the spread- 
ing of this horrible disease, and being so well qualified for that 
work by study and experience, and so well equipped with instru- 
ments, we are of opinion that his removal and the consequent inter- 
ruption of the important work in which he has been hitherto en- 
gaged, will be little short of a public calamity, and will produce 
most unfavorable criticism in all other civilized countries. 

We therefore hope that it may yet be possible to induce the 
Board of Health to reconsider its action, at least so far as to allow 
him all necessary aid and facilities for thorough and continuous 
experiments and investigation, and that you may be able to guar- 
antee the payment of Dr. Arning's salary for two years without 
calling upon the Board for any help in that matter. It is a duly 
which we owe to our profession and to the public to make this 
statement, and to record our conviction that a grave error would 
be committed by any interruption of the investigations which Dr. 
Arning has conducted during the past two years. 

We remain, gentlemen, respectfully yours, 

G. TROUSSEAU, M. D. 
JOHN BRODIE, M. D. 
JNO. S. McGREW, M. D. 
N. B. EMERSON, M. D. 
MRS. DR. EMERSON, M. D. 
ROBERT McKIBBIN, M. D. 
CHARLES T. RODGERS, M. D. 
G. H. MARTIN, M. D. 
S. G. TUCKER, M. D. 
HENRI G. McGREW, M. D. 



348 THE PATH OF THE DESTROYER 

Office of the Board of Health, 

Honolulu, January 30, 1886. 

To Messrs. C. R. Bishop, F. A. Schaefer and J. B. Atherton. 

Gentlemen: His Excellency, the president of the Board of 
Health, has instructed me to acknowledge the receipt of your 
letter (and its enclosures) of January 28, 1886, in which you 
state that: "A number of the physicians of Honolulu, and many 
other gentlemen, resident here, consider it of very great importance 
that the investigation by Dr. Arning, applying to leprosy, should 
be continued in a thorough manner for a further period of two 
years; and, believing that the Board of Health will be not only 
willing, but quite desirous of co-operating in a work which may 
be of inestimable advantage to this country, and of value to the 
cause of science and humanity the world over, by granting such 
facilities and moral support, as are and may be within its power, 
the undersigned, a committee appointed by the subscribers to a 
fund in aid of such investigation, are authorized to assure Your 
Excellency that if such support and facilities as are necessary are 
granted by your Honorable Board for the period above stated, the 
salary of Dr. Arning will be paid from said fund." 

In reply, I beg to say, on behalf of the president of the Board 
of Health, that the past history and conduct of His Excellency, 
in connection with the disease of leprosy on these islands, have 
proved his sincerity, energy and anxiety in the matter of dealing 
with it, both as a legislator and as a minister. It is, perhaps, un- 
necessary to remind you, gentlemen, of His Excellency's successful 
efforts to induce the legislature of 1878 to grant the appropriation 
of $10,000 for the medical scientific investigation of leprosy, or 
that it was at His Excellency's own suggestion, and by his cor- 
respondence with Dr. Hillebrand, and his own personal influence 
and exertion, that Dr. Arning himself came to this country to pur- 
sue his studies and experiments as a medical scientist, under the 
patronage of the Hawaiian government. 

It is, perhaps, equally unnecessary to refer, upon this occasion, 
to other practical measures for the benefit of the leprous sick of 
the kingdom, which have been initiated and carried out by His 
Excellency and his colleagues, except to enable you, gentlemen, to 
bear in mind that His Excellency's endeavors, in the interest of the 
lepers and the public health generally, are unwearying and un- 
abated. 

In regard to the decision of the Board of Health "to dis- 
continue the appointment of Dr. Arning," I would beg to recall to 



THE PATH OF THE DESTROYER 349 

your memories the following extract, from a portion of a letter 
from Dr. W. Hillebrand to His Excellency, dated Necember 16, 
1882, and published in the report of the Board of Health to the 
Legislature of 1884: "That in consideration of the important re- 
sults from the intended investigation on the contagium of leprosy, 
the Hawaiian government declares itself ready to assist Dr. Arning, 
either by a direct grant or otherwise. The sum in question is 
very moderate, simply large enough to cover the expenses of living 
on the islands for the space of nine months. I imagine that you 
will be justified to set aside a small portion of the money appro- 
priated by the Legislature for sanitary purposes. If not, you can 
appoint him physician to the Leper Settlement, where Dr. Arning 
will be obliged to spend the greater part of the time." 

Dr. Arning arrived in Honolulu the 8th of November, 1883, 
and has received from the Hawaiian government a salary, as a 
government physician, of $150 a month since that time, altogether 
with sundry outlays in connection with his experiments, making 
an aggregate of over four thousand three hundred dollars ($4,300). 
The period contemplated for his proposed investigations, and the 
cost thereof, have, as you gentlemen will readily observe, been con- 
siderably extended, in the hope of securing tangible results in the 
cause of medical science. 

His Excellency, consequently, after the lapse of so much 
greater time than was originally anticipated, and the very liberal 
expenditure of public monies, desired to obtain from Dr. Arning 
such a report of the progress of his labors as would give to the 
incoming Legislature some strong evidences of justification for the 
expenditure, be an indication of future requirements and appro- 
priations, and an aid to the consideration of the ultimate value of 
such investigations to the Hawaiian people and the world at large, 
and the outlining of the course to be pursued in connection with 
them, by co-operation, development or otherwise. 

Upon the receipt of Dr. Arning's report by His Excellency 
in November last, a correspondence (of which printed copies are 
enclosed) ensued, which terminated in the Board of Health dis- 
continuing Dr. Arning's services. Retrenchment was not given as 
a reason, as this correspondence plainly shows; and, as a matter of 
fact, the scientific investigation of leprosy will be continued by the 
Board. Dr. Arning, as you gentlemen will read, was requested by 
His Excellency to supplement his report with further information 
— a most reasonable request and one which it might readily be 
anticipated a willing student or investigator, receiving the financial 




HENRY P. BALDWIN. 



Of Hawaiian Missionary stock, born 1842, died 1911. Founder of the 
Baldwin Home at Kalawao, Molokai. One of the foremost captains in the 
sugar industry, multi-millionaire, resident of the island of Maui. Good, 
generous friend to the Hawaiian people. Able and sagacious in finance 
and politics. 



THE PATH OF THE DESTROYER 351 

and moral support of the government, would accede to. The 
terms of the declination appear. Upon His Excellency receiving 
Dr. Arning's assurance that it was not his intention to contribute 
the information required, and that practically, the information was 
intentionally withheld, from motives other than those of humanity 
and science, and the enabling the Hawaiian government to intelli- 
gently consider the value to the country of Dr. Arning's elaborate 
experiments and labors, it was deemed proper to cancel an ap- 
parently unlimitable engagement — at any rate, until the meeting 
of the Legislature. 

His Excellency's desire has been to lay the foundation in this 
city of a repository of medical knowledge for the use of all medi- 
cal men and others interested in leprosy, and to collect there for 
reference, specimens, photographs, notes of cases and experiments, 
books of reference, and so forth, such as would be of infinite value 
to medical observers and practitioners. As a preliminary to this 
His Excellency has obtained from foreign governments the infor- 
mation referred to in the correspondence with Dr. Arning, and 
it was not unreasonable to expect that a distinguished scientific 
student, "commissioned by one of the highest scientific bodies," 
from no motives of gain, but prompted by the simple enthusiasm 
of science and philanthropy, would cheerfully avail himself of an 
opportunity to aid his fellow men in so philanthropical a cause. 

His Excellency desires me to express his cordial commendation 
of the humane and patriotic spirit which has induced you, gentle- 
men, and others, to provide for Dr. Arning's salary for two years 
in order to enable him to continue his investigations, and I am 
instructed to say that His Excellency will be glad to provide all 
such facilities and moral support as may be accorded within the 
law, by the Board of Health, to promote scientific or other investi- 
gations or experiments, by any foreign physicians coming here ac- 
credited by a scientific body, or by their respective governments. 

As Dr. Arning has already had over two years' experience in 
the investigation of leprosy in this country, His Excellency will be 
glad to afford him further opportunities to study the disease, under 
what he deems most favorable conditions, with all the surround- 
ings that could be desired by a humane and earnest scientific investi- 
gator — by enabling him to pursue his investigations at the Leper 
Settlement on Molokai. At that place there are upwards of 600 
lepers of all ages, sex, and condition, and in varying stages of the 
disease; and, furthermore, Dr. Arning will find there several of 



352 THE PATH OF THE DESTROY ER 

his former patients whom, he says in his report, were removed from 
his charge and treatment. 

His Excellency will recommend to the Board that Dr. Arning 
be provided with a house at the Settlement for a private residence, 
with out-buildings for small hospitals and laboratory, and such 
patients as he may desire to have placed under his special charge 
under conditions not in conflict with the general medical manage- 
ment of the physician of the Settlement. His Excellency will also 
recommend that Dr. Arning be provided with rations, or an allow- 
ance in lieu thereof ; with one or two riding horses, and with one 
or more animals, such as sheep, hogs, etc., that can be found at 
the Settlement, and may be required for inoculation or other 
experiments. He will be permitted a reasonable liberty of action, 
and all facilities and moral support within the power of the Board 
of Health to accord to him. 

I have the honor to be, gentlemen, 

Your most, obedient servant, 

FRED H. HAYSELDEN, 

Secretary Board of Health. 

* * * 

Honolulu, February 8, 1886. 

His Excellency W. M. Gibson, 

President of the Board of Health. 

Sir: We have the honor to acknowledge the receipt of the 
letter of the secretary of the Board of Health, in reply to our letter 
of the 28th ult., to Your Excellency. 

Without attempting to reply to all points in the secretary's 
letter, we will give our attention to that part most pertinent to 
the object we are charged with — that is, the paragraph which reads 
as follows: "As Dr. Arning has already had over two years' ex- 
perience in the investigation of leprosy in this country, His Excel- 
lency will be glad to afford him further opportunities to study the 
diseases under what he deems most favorable conditions, with all 
the surroundings that could be desired by a humane and earnest 
scientific investigator, by enabling him to pursue his investigations 
at the Leper Settlement on Molokai. At that place there are up- 
wards of 600 lepers of all ages, sex, and condition, and in varying 
stages of the disease; and furthermore, Dr. Arning will find there 



THE PATH OF THE DESTROYER 353 

several of his former patients whom he says in his report were re- 
moved from his charge and treatment." 

As Dr. Arning has heretofore been permitted to pursue his in- 
vestigations at Kakaako (the branch hospital for lepers), as well as 
at the Leper Settlement on Molokai, and as those acquainted with 
the two localities, know the former affords many conveniences and 
advantages (to say nothing about the greater personal risk and 
privation at the Settlement), which could not be provided at the 
latter without large additional expense to the physician, as well as 
to the treasury, and in some important particulars could not be 
provided at all, we cannot regard the letter of the secretary, as 
it now reads, otherwise than as withholding suitable facilities for 
further investigation by Dr. Arning. You, no doubt, anticipate 
his declining to be confined to the Molokai Settlement, and he will 
have no reason to fear that his reputation as a "humane and earn- 
est scientific investigator," will be compromised by so doing. There 
is no doubt as to the liberal disposition of the Legislature of this 
country in the past, or for the future in all matters relating to the 
public health, and that body is not likely to regard the sum al- 
ready expended, or that will be required in the future for Dr. 
Arning's services if he is permitted to continue them, as excessive 
or mis-spent. 

Dr. Arning is, we believe, the first scientific investigator who 
has come from abroad, to devote himself to the study of leprosy, 
since the government began to care for the lepers, and if he is 
compelled to stop in the midst, of his work for lack of support and 
facilities within the control of the Board of Health, it is unlikely 
that any other foreign physician "accredited by a scentific body, or 
by his government," will offer his services for a like purpose. 

Without further preliminary, we now beg to state what Dr. 
Arning considers requisite in order to pursue his investigations in a 
manner most likely to lead to valuable results, which is substantially 
as follows: Free access to the branch hospital at Kakaako, and to 
the Leper Settlement on Molokai, for himself and his assistant, and 
to all of the inmates at both places; a separate hospital ward of 
eight beds at Kakaako, for four male and four female cases to be 
selected by himself; the ward to be fitted and appointed as stated 
in his late report to the Board of Health ; a room attached to the 
ward with a northerly light, and with water, etc., for special work: 
a convenient place for such animals as are necessary for experi- 
ments; and also the firm and hearty support of the Board, in cer- 
tain work which may not be agreeable to the mind of the patients, 



354 THE PATH OF THE DESTROY ER 

but which forms a most essential part of the investigation, i. e., 
regulation of diet, post-mortems, etc. ; and finally, it should be un- 
derstood that no patient will be removed from his care without his 
knowledge and without, reason given therefor. 

If, in the foregoing, anything is asked for which cannot be 
granted, we shall feel much obliged if Your Excellency will state 
what item it is, so that we may see whether or not it can be omitted 
or arranged for in any other way; but if the Honorable Board of 
Health will not grant the facilities within its control, or declines 
to provide such facilities at Kakaako, then the purpose of those who 
are willing to assist with their means in promoting this important 
investigation in the interest of the public, will be defeated, and 
Dr. Arning will not be detained any longer, a result which we 
should greatly regret. 

We remain, sir, your obedient servants, 

CHAS. R. BISHOP, 
F. A. SCHAEFER, 
J. B. ATHERTON, 

Committee. 



Office of the Board of Health, 

Honolulu, February 10, 1886. 

To Hon. Charles R. Bishop, F. A. Schaefer, Esq., and J. B. 
Atherton, Esq. 

Gentlemen: I have the honor to acknowledge receipt of your 
letter of the 8th inst., and have to say, in reply, that I am some- 
what surprised at its contents, especially at the tone in which the 
declination of the offer made by me in behalf of the Board of 
Health to you, on Dr. Arning's behalf, is conveyed. 

Apparently it would be useless to reiterate or enlarge upon 
the advantages, which I believe the Leper Settlement on Molokai 
(the chief center of the disease, where there are over 600 cases 
of confirmed leprosy), possesses over the branch hospital at Kaka- 
ako (with barely one hundred cases of a much milder type), for 
such a line of investigation as is proposed by you for Dr. Arning. 

It suggests itself in this connection, to my mind, that the 
assistance and co-operation of such an able and experienced physi- 
cian, as the resident physician at the Settlement, should be worthy 
of some consideration, as it might be of practical benefit to Dr. 



THE PATH OF THE DESTROY ER 355 

Arning, who certainly could endure, equally with Dr. Mouritz, in 
the cause of science, "the greater personal risk and privation at the 
Settlement." 

The uncalled for assumption conveyed by the expression, "you 
no doubt anticipate his declining to be confined to the Molokai 
Settlement," compels me to believe that Dr. Arning has met with 
unwise advisers, whose course of action throughout has been dic- 
tated, not entirely for the public welfare, nor by philanthropic in- 
terest in the progress of Dr. Arning's labors on behalf of the lepers; 
and I regret that, even in the cause of the sick, unworthy prejudices 
are permitted to intrude where charity, as well as science, should 
be supreme. 

The ultimatum, it can scarcely be called a request, of "what 
Dr. Arning considers requisite,'' I deem it necessary to say, must 
be emphatically declined. In my opinion the proposal is one of 
such an important character in its present bearings, and future con- 
nections with established departments of the government, that it 
should be reserved for legislative discussion and action, in connec- 
tion with other kindred plans and proposals relative to leprosy. 

To grant the demands of those who claim to speak on behalf 
of Dr. Arning, would be practically to create an irresponsible extra- 
medical department for leprosy, capable, perhaps, in the hands of 
Dr. Arning, individually, of doing much good ; but, at the same 
time, possessing the elements of discord, and the possibility of cre- 
ating considerable confusion and mischief. Furthermore, it would 
be establishing a precedent for creating indirectly a new and largely 
salaried office, the responsibility of which I do not feel inclined to 
advise the Board of Health to accept. 

I beg to say, gentlemen, that I do not impute to you such a 
motive, in your anxiety on Dr. Arning's behalf, but I feel it proper 
to intimate that such a result would be a possible sequence to your 
efforts — if successful. 

I regret that the offer made to Dr. Arning, on behalf of the 
Board of Health, in the letter of the secretary of the Board, of 
the 30th ult., has been declined. 

I have the honor to be, gentlemen, 

Your most obedient servant, 

WALTER M. GIBSON, 

President Board of Health. 



SPECIAL REPORT 
OF ARTHUR MOURITZ, M. D. 

Physician to the Leper Settlement and Island of Molokai. 



To His Excellency W. M. Gibson, 

President of the Board of Health. 

Sir: I have the honor to submit my report on the Leper 
Settlement, and at the same time treating in detail the suggestions 
contained in the letter of the secretary of the Board, dated De- 
cember 21, 1885. 

Whilst submitting the statements contained in my report, I 
think it almost superfluous to draw Your Excellency's attention to 
the difficulty attached to the prosecution of inquiries on the sub- 
ject of leprosy in this kingdom, as knowledge of a clear and con- 
cise nature, from the very obstruseness of the subject, can scarcely 
be gained. 

The materials for drawing up true and reliable information 
do not exist in this country, or if they do exist at all, it is only 
within a very recent period ; books, papers or any printed or writ- 
ten records are for the most part wanting. Viva voce interrogation 
of old residents (foreigners) give rise to such diversities of opinion, 
that only doubt and increased perplexity ensue in the mind of the 
interrogator; such means of seeking the truth, however, must be 
put aside. Again, on the other hand, an obstacle of no small 
moment arises in the total unreliability of the information received 
from the natives themselves, from want of a thorough comprehen- 
sion and appreciation of the great importance and aim required in 
answering questions pertaining to scientific enquiry. To sum up 
briefly, no satisfactory information, bearing on the subject of lep- 
rosy in all its phases, can as yet be given. 

I wish at the outset to state that my personal views, and the 
information set forth generally, will, as far as possible, deal with 
the subject of leprosy as met with in the Hawaiian Islands; also, 
that my statements and deductions apply to my own personal field 
of observation chiefly, viz., the Leper Settlement on Molokai. 

As to the origin of leprosy in these islands. — On this point 
I must confess I have not found any information sufficiently re- 
liable to be put on record as authentic. 

When I first entered this country, a few years ago, I asked 
about the origin of leprosy, interrogating physicians and many 



358 THE PATH OF THE DESTROYER 

laymen on their own views of the matter, or if they had met with 
hearsay evidence. No two replies were alike, but most agreed that 
leprosy^did not prevail extensively in these islands before the year 
1860, some twenty-six years ago. If cases of the disease did 
exist previous to this date, they did not obtrude themselves on 
public view to a sufficient extent so as to be noticeable, or to 
call for any general comment. 

According to the information set forth by Dr. Hillebrand, 
leprosy was introduced into Honolulu by the Chinese in the year 
1848, and the doctor saw the first Hawaiian leper five years later; 
ten years afterwards the disease had spread considerably in the 
immediate neighborhood of presumably the first propagated Ha- 
waiian case. 

These facts, as related by Dr. Hillebrand, are very valuable, 
and in so far as Honolulu is concerned, may be quite sufficient to 
account for the appearance and spread of leprosy there. But to 
conclude that from this focus the disease spread over the entire 
group, such a conclusion is open to many objections. Undoubtedly 
there must have been other forces at work to cause the disease to 
increase to its present proportions on all the larger islands. It is, 
however, quite possible that the Chinese carried leprosy primarily 
to other places on the group besides Honolulu. 

The Segregation of the Lepers. — About the year 1864 the large 
increase in the number of lepers commenced to agitate the mind of 
the community, and steps were taken to adopt measures to check 
the spread of the disease, and the law of segregation was en- 
acted in January, 1865. 

In November of that year a small hospital was established 
near Honolulu, at Kalihi, capable of accommodating about fifty 
inmates, where a somewhat systematic inspection could be made of 
those who were brought to the hospital as lepers, many persons 
being arrested in error, the disease not being leprosy. These, of 
course, were liberated ; the mild cases, and those of moderate de- 
grees of severity to whom some good might be expected to accrue 
from improved conditions of living and medical treatment, were 
kept in the hospital; the confirmed and hopeless cases were sent 
to the permanent settlement, the site of which had been selected 
at Kalawao, on the island of Molokai. 

Dr. Hoffman, of Honolulu, who was connected with the 
Kalihi hospital at its establishment, has kindly given me the fol- 
lowing information: "Generally fifty cases were under treatment 
from time to time in the hospital, the cases being equally divided. 



THE PATH OF THE DESTROY ER 359 

The two usually described varieties of the disease existed, viz., the 
tubercular and the anaesthetic; the former, as is usual, predomi- 
nated. During my charge between 600 and 700 lepers were trans- 
ferred to Kalawao. I found no permanent benefit from treat- 
ment; better food and cleanliness, medicine, suited to improve the 
general health of the leper ameliorated the disease temporarily." 

The hospital at Kalihi was abolished in the year 1875. Dur- 
ing its existence about forty lepers died there, and some ten de- 
serted, but all the others who had passed through its portals (the 
diagnosis of the disease being certain) finally reached Molokai; 
many, however, being conveyed direct to the Settlement from the 
other islands. 

The Leper Settlement. — The Leper Settlement on Molokai is 
situated about the center of the north or windward coast of the 
island, and in so far as the question of isolation from the adjacent 
portion of the land is concerned, a better site could not have been 
chosen. Nature herself having disconnected the upland from the 
plain below; the intervention of a steep and lofty mountain chain 
completely encompassing the plain on the landward side. The 
plain is in the form of a tongue of land, two sides being washed 
by the ocean, the third or the base of the tongue ending in per- 
pendicular cliffs, washed by the sea, affording no egress or ingress, 
except by boat or canoe. The extreme length of this tongue of 
land, which runs almost due north and south, is about two and 
three-quarters miles, at the base where the said portion of land 
joins the mountains its width is three miles, at the center of the 
tongue two and one-half miles wide, and seaward toward the apex, 
one mile wide, comprising approximately four square miles of sur- 
face, richly covered was grass, but totally devoid of trees. On the 
eastern side close to the base of the mountain lies the village of 
Kalawao. At a similar situation on the western shore, but fur- 
ther removed from the mountains, lies the village of Kalaupapa, the 
chief port of the Settlement, where merchandise, food, etc., are 
generally landed. Three-quarters of a mile seaward of Kalaupapa 
lies the small village of Iliopi. Makanalua is placed close in to 
the mountains, midway between Kalaupapa and Kalawao ; im- 
mediately opposite and to the seaward of this village rise the walls 
of the extinct crater of Kauhako, which attains an elevation of 
493 feet above sea level. This crater, when active, in conjunction 
with the soil washed from the adjacent gorges and sides of the 
mountains, has formed the lands which comprise the Leper Settle- 
ment. 



360 THE PATH OF THE DESTROYER 

From the eastward edge of Kauhako the land trends towards 
the sea, and ends in rugged, steep cliffs one hundred feet high, 
making access to the seashore a difficult and almost impossible under- 
taking. The north shore resembles the eastern, but the cliffs are 
less elevated — about fifteen to twenty feet and honeycombed by 
the force of the ocean. The northwest shore is level with the sea, 
and affords easy access to it, which, as the western shore is con- 
tinued landward, becomes more difficult, even off Kalaupapa — the 
port. There is a considerable break in the rim of the crater of 
Kauhako towards the northeast, where the lava has burst out; the 
elevated edges of this channel trend from northeast to north, form- 
ing a barrier which breaks the force of the northeast trade wind, 
and thereby affords some shelter to Kalaupapa. The village of 
Kalawao, as I have mentioned before, is situated on the eastern 
side of the Leper Reservation, and is exposed to the full force of 
the northeast trade wind — the usually prevailing wind — which as- 
sumes the proportion of a gale for days and weeks together, and 
it is chiefly on this account that the land is devoid of trees, to- 
gether with the wind being strongly impregnated with saline 
matter. 

During many days in the winter months the climate of Kala- 
wao is most ungenial, being bleak, cold, and rainy; these con- 
ditions being of comparatively no inconvenience to the healthy, 
but to the leper a serious drawback. Then, again, the high cliffs 
towering 3,000 feet above the village, effectually shut out the direct 
rays of the sun from the early hours of the afternoon. 

Kalaupapa faces the west, is sheltered by Kauhako from the 
prevailing wind, is further removed from the base of the moun- 
tains, and, therefore, has the direct benefit accruing from the sun's 
rays. The abundance of the grass affords evidences of a con- 
siderable rainfall, and this is the experience of the residents. In 
205 days, dating from early in November, 1884, to the end of 
May, 1885, (the rainy season here occurring in the months of 
November, December, January, and February), rain fell on 101 
days, sometimes continuously for days together; notably the end of 
April and beginning of May. I was informed, however, that 1885 
was an unusually wet year. 

The slope of the surface and the geological formation (lava 
rock covered with a foot or two of soil) conduce towards good 
drainage, so that the heavy rainfall does not affect the health of 
the residents as it would do provided the surface water had oppor- 
tunity of storage, which would then occasion subsoil dampness, with 




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362 



THE PATH OF THE DESTROY ER 



its concomitant evils, excess of rheumatism, catarrhal complaints, 
and phthisis, etc. 

The mountain range, which shuts off the Leper Settlement, is 
continued east and west the whole length of the island of Molokai, 
gradually reaching a less elevation towards the westward, but to- 
wards the east rising until finally the mountains acquire an eleva- 
tion of from 3,000 to 4,000 feet. The seaward side of this range 
of mountains, as viewed from Kalawao, is bold and rugged, and 
after a rain storm, when numerous cascades fall from the moun- 
tain sides, the grandeur of the scenery is much enhanced ; deep 
gorges, shut in on three sides by towering ramparts of rock, alone 
accessible by sea, further beautifies the natural scenery. 

The appended table shows the average daily temperature in the 
shade, taken at 12 m. for eleven months: 

Centigrade Scale 

1884, November . 23.4 

December 22.2 

1885, January 20.0 

February 19.5 

March 21.5 

April 20.8 

May 21.3 

June 

July 26.0 

August 26.0 

September 25.3 

October 24.3 

The water supply of Kalawao is obtained by partially dam- 
ming a mountain stream, and from this storage it is conducted in 
pipes and distributed at intervals through the village. The quan- 
tity of water is mainly dependent, if not altogether, on the rainfall, 
which I have stated already is abundant, drought, being a rare oc- 
currence; but the storage capacity of the reservoir is too limited. 

Kalaupapa has several springs situated on the beach; the quan- 
tity of water they supply is sufficient for domestic wants, but it 
is not overabundant. Its quality is not good, being largely impreg- 
nated with chlorides, and if other sources of potable supply could 
be conveniently obtained, it would be highly desirable to dispense 
with its use for drinking purposes. 

The dwellings provided for the lepers by the Board of Health 
are built of wood, whitewashed in and out, and are fairly com- 



THE PATH OF THE DESTROYER 363 

iortable, being a great advance on the accommodation provided in 
the early years of segregation. 

The average accommodation provided for each leper is a 
cubic space of about 500 feet; at the present time, as the Settle- 
ment is not very full, each leper has nearly 1,000 feet of cubic 
space in his or her dwelling. Wooden houses not being air-tight, 
1 ,000 feet of cubic space is ample for mild cases of leprosy ; but all 
bad cases should be accommodated on the basis of infectious diseases, 
and provided with not less than 2,000 feet of cubic space, with 144 
square feet of floor for each individual case. 

The question of ventilation also requires careful consideration. 
The system at Kalawao has apparently never had attention given 
to it, and the result is that either the leper is chilled to the mar- 
row or he is poisoned by his own exhalations. Many of the lepers 
are encouraged by the Board to build better houses for themselves, 
and some are erected quite pretentiously, neat and clean in and 
out, approaching quite a degree comfort. 

The dwellings of the lepers are kept fairly clean by the in- 
mates; surrounded by a stone wall, enclosing half an acre or so, 
also adds to the better appearance of the cottages. Within this 
enclosure sweet potatoes, bananas, sugar cane, and onions are gen- 
erally cultivated, the edibles thus obtained adding materially to 
the ration of food allowed by the Board. 

The interior of the Hawaiian house, generally, is devoid of 
furniture, the floor-mat or mats forming bed, bedstead and chairs; 
a few calabashes for food complete the equipment of Hawaiian 
domestic life. So it is carried on at the Settlement. 

At Kalawao is situated the hospital or home, where the worst 
cases are supposed to be accommodated. The site of this establish- 
ment is on the hill-side, about half a mile from the sea, and com- 
prises an area of less than two acres, surrounded by a picket 
fence. Five wooden buildings, about 40x15, and six smaller 
erections, comprise the accommodation, the usual offices for pre- 
paring and storing food being in close proximity. Food, washing, 
and lodging are provided for the inmates, medical treatment if 
desired, and some attempt at nursing; but its main claim on the 
Hawaiian, appears to me, that he is saved the trouble of pre- 
paring his food, washing his clothes, and procuring fuel. 

Of course there are no cases of cure, and those who enter 
its portals remain till death releases them. Generally the Ha- 
waiian is prejudiced against hospital restraint and treatment, not 
only here, but all over the islands. Many of the worst cases pre- 



364 THE PATH GF THE DESTROYER 

fer to remain outside; the very cases the hospital was intended 
for, do not avail themselves of the benefits we, as foreigners, 
think belong to such institutions. Whenever I have suggested 
to any sufferer outside, whom I thought would be benefited by a 
residence in the hospital, and the desirability of having him removed 
there, with scarcely an exception the answer has been, "I prefer to 
remain and die where I am." From these remarks, it is scarcely 
necessary to add that I have not thought it advisable to suggest 
to the Board that a post-mortem room, operating theatre, etc., and 
other such requisites for ordinary every-day hospital routine, should 
be added to the present buildings. For, had I any of these fa- 
cilities, I could make but little use of them, as prejudice against 
innovations, and foreign medical ideas prevails largely. 

With a few remarks on segregation, I will conclude this 
section of my report. 

Very few lepers surrender themselves voluntarily — to do so is 
not the rule, but the exception; on the other hand, resistance is 
rarely offered to the execution of the law, the Hawaiians being 
a peaceful people; in this alone, when the execution of sanitary law 
is enforced, showing a lustrous example to many ancient nations, 
presumably more enlightened, who even now assail the execution 
of the simplest needful sanitary measures, the detention of the in- 
dividual not being in the question. That lepers are frequently 
secreted by their friends is true, and quite natural that such should 
be the case, as no dread of the disease is manifested amongst the 
Hawaiians. The healthy live in the same house, eat out of the 
same utensils, sleep together in the same bed as the leper; all these 
conditions of life bringing them closely in contact with the disease, 
and by this means leprosy is, in my opinion, only too certainly and 
too frequently spread. 

The law of segregation is actively enforced as follows : On 
notice or complaint being given to the sheriff of the district in which 
a leper resides, he (the sheriff) notifies the sufferer to appear be- 
fore a physician (always a foreigner), or brings the leper to some 
public office (say courthouse), then notifies the nearest foreign 
physician to attend and examine the case, whether of leprosy or 
not. If the diagnosis is certain, then by the easiest method and most 
convenient route or conveyance, the leper is removed from his home, 
either direct to Molokai, but more generally to the receiving-house 
at Kakaako, for further medical examination before being segre- 
gated finally. 

That all lepers should be segregated I quite agree; that all 



THE PATH OF THE DESTROY ER 365 

lepers could be segregated is quite a different matter, and almost 
impossible, in fact. Severe cases generally become public nuisances, 
and are dealt with first; though even if left at large, they have the 
advantage of acting as danger signals to the foreigner, and to the 
populace generally, in nearly all countries but Hawaii. The in- 
habitants of the islands (the indigenous ones I mean) have always 
shown an utter disregard and ignorant contempt for leprosy, which 
slowly, but silently, seizes its victims; in fact, according to our 
foreign ideas of the manner disease is spread, the Hawaiian makes 
every effort to saturate his system with the germ of leprosy — that 
many only too well succeed, and thereby pay the penalty with their 
lives, will be shortly indicated in my tables, showing the arrivals 
and mortality at the Leper Settlement. In my opinion, the great 
defect of the law of segregation of lepers lies in the fact that it 
carries no moral weight, and fails to get at the root of the evil; 
and until such time as the Hawaiian mind is impressed with the 
necessity of social ostracism being practiced towards all lepers, not 
till then will the true advantages of public segregation in chosen 
sites be made manifest. Did social ostracism exist at the present 
day amongst the Hawaiians, as regards the leper, probably the non- 
contagious view of the disease might receive considerable support. 

Lastly, whether segregation as carried out for the past twenty 
years, has had any beneficial effect on staying the progress of lep- 
rosy I cannot offer an opinion, my residence in the country being 
too brief. 

In my statistics I have eliminated all kokuas, male and female 
(non-lepers), who had been placed on the list as lepers, but draw- 
ing rations ; these people entered into the lists of arrivals and deaths. 

The rule of the Settlement, placing all children born in it on 
the leper ration list, swells the death list and the arrivals. When 
their death took place under twelve months, I have invariably struck 
them out of my mortality figures, as it was most probable that 
they had not then become lepers. It happens, therefore, that there 
are a greater number of names on the list of lepers than I take 
account of, for the reasons above stated. 

In twenty years (1866-1886), the male Hawaiian lepers show 
an excess of 809 over the females; or, briefly, the male lepers ex- 
ceed the females in the ratio of 19 to 11. 

Again the excess of mixed Hawaiian blood, Caucasian and 
Asiatic-Hawaiian males, over females of mixed Hawaiian blood is 
shown as under: 




REV. FRANCIS W. DAMON. 

Born in Honolulu December 10, 1852. Died at Moanalua June 22, 1915. 

A refined, courteous gentleman, an accomplished Chinese scholar, and a 
guiding Pole-star to the Chinese in Hawaii in all matters tending to their 
elevation. His peculiar fitness for his chosen life work was such, "that no 
other can fill his place." 

The late F. W. Damon was the friend, spiritual adviser and comforter 
of the Chinese lepers in Kakaako and Kalihi hospitals. 



THE PATH OF THE DESTROYER 367 

Males . 270 

Females 90 

Excess 180 

So that male mixed blood exceeds that of the same female race 
in the proportion of 3 to 1. 

The excess of the male lepers over the female is no exception 
to the information received, on the same question, from all other 
countries where leprosy exists. The male lepers invariably exceed 
the female (I know of no instance to the contrary), due regard 
being paid to the excess of males over females in the general popu- 
lation. 

In regard to the number of lepers segregated annually. In 
the year 1873, four hundred and eighty-seven lepers were sent to 
the Settlement. With this large accession the number on the list 
reached 809, comprised of 498 males, and 311 females. 

Again, ten years afterwards, another large reinforcement was 
received at the Settlement; this was in the year 1883, when 301 
lepers were added to the list. On August 19, 1883, the daily re- 
corded list shows a total of 841 souls, these 841 persons being 
comprised of 512 males and 329 females. The smallest number 
of lepers received at the Settlement in any one year since its foun- 
dation was in 1880, 51 persons being placed on the books as fresh 
arrivals. 

ADDENDA 

(In the year 1888, 345 males and 226 females were segre- 
gated, total, 571 — the largest number in any one year. On Janu- 
ary 1, 1890, there were 1,213 lepers on the list — highest number 
in the history of segregation.) 

The numbers under the head "discharged" comprise the fol- 
lowing cases: 

1. Non-lepers — these comprise the majority. 

2. Sent to Honolulu for treatment. 

3. Sent to Kapiolani Home. 

4. Removed for crime. 

The mortality figures need no special analysis into per cents, 
the number of leper residents being so small. The largest number 
of deaths in any one year occurred in 1879, when the mortality 
reached the total of 209, or 26 per cent; but then it must be taken 
into account that there were a larger number of lepers on the list 



168 



THE PATH OF THE DESTROY ER 



January 1, 1879 (viz., 802), than in any other year at a similar 
date. 

The average mortality per annum for the first decade amounts 
to 22 per cent, approximately, and the average annual mortality 
for the second decade is 20 per cent. The greatest number of 
deaths recorded in any one month was in May, 1880, the total 
reaching 38. 

I have collected and tabulated 1,812 cases of leprosy, the books, 
unfortunately, not permitting me to analyse the whole number of 
native lepers received since the foundation of the Settlement (Janu- 
ary 6, 1866) ; these amount to 2,997 persons. 

The headings of the following table show the analyses of these 
1,812 cases, chiefly in the matter of the insular distribution. Three 
of the main islands (Kauai, Oahu and Hawaii), as regards the 
number of lepers to the whole population of each island respectively, 
give almost the same result. 

Maui shows an excess of lepers to its population, viz., 1 to 17, 
in comparison with the three other large islands. This island 
(Maui) also stands out piominently with "district excess'' of lepers, 
calculated per one hundred inhabitants. 

There are also several local districts included in the main dis- 
tricts in which the number of cases of leprosy segregated from these 
said smaller local districts appears excessive; whether so relatively 
to the population I have no means of accurately determining, the 
census returns simply giving the population in bulk. 

Such excess for local districts are given in this table, the num- 
ber of lepers being equal in several: 



Kauai 
Oahu 
Oahu 
Maui 
Maui 
Maui 
Hawaii 



Local District 



Hanapepe 
Kaneohe 
Heeia .... 

Kaupo .. 
Waikapu 
Wiaihee .. 
Waipio .. 



Number of Lepers 



18 
18 
15 
15 
18 
34 
37 



GEOGRAPHICAL DISTRIBUTION AND PREVALENCE 



The following tabulated statement shows an analysis of 1,812 
cases of leprosy, taken from the records at Kalawao (calculations 



THE PATH OF THE DESTROYER 



369 



approximate, fractions omitted, and native population only dealt 
with), showing number of lepers in each district in proportion to the 
population: 



Island 


District 


No. of 
Lepers 


Proportion of 

Lepers to 100 

Population 


Ratio of Lepers to 

Whole Population of 

Each Island 


r 


Koolau 


} +» 

34 
I 80 

408 

30 

13 

38 

31 

35 
111 
166 

64 

47 

67 

20 
107 

75 
125 

23 

38 
126 

89*(1) 

34 
3 


1 * 

3 

1 5 

4 

I s 
j 6 

6 
3 
3 

7 
6 

3 

1 
I 

I 7 
j 

4 

5 

5 

3 

3 

4 

22 

3 

2 


1 
j 


Kauai | 


Halaleia 

Puna 


< 

Niihau 1 


j> 1 to 23 
i 


1 Kona 

1 Niihau 


r 

i 

Oahu j 


J 
i 

i 


Honolulu 


Ewa 

Waianae 

Waialua 




>- 1 to 23 


I 

i 


Koolauloa 


1 


i 

r 


Koolaupoko 

Kona 

Wailuku 


1 

j 

1 

1 


IVIaui ! 


Makawao 

Hamakua 

Hana 


i 
I 


> 1 to 17 

i 


r 

i 


Kahikinui 


J 

1 


Kohala 


Hamakua . 




Hilo 


1 




Puna 


y 1 to 24 


! 


Kau 


i 


1 


Kona 


1 

J 1 to * 


Koolau 


Molokai . j 


Kona 


1 to 29 


Lanai 


Lanai 


1 to 50 












1,812 







* ( 1 ) Formerly kokuas, now lepers at Kalawao. 



370 THE PATH OF THE DESTROY ER 

CONTAGION.— The whole history of leprosy in the Ha- 
waiian Islands from its introduction to its present rapid spread and 
development, verily proves that it can only be accounted for by re- 
garding it as a contagious disease, and that it spreads from indi- 
vidual to individual. Whatever else may be said of its being non- 
contagious in other ancient countries, where the disease exists en- 
demically, these statements do not apply, or should not apply, to the 
disease in the Hawaiian Islands. Even in other countries where 
the disease has existed for centuries, the question of contagion or 
non-contagion is not definitely settled, the evidence tending in many 
cases to affirm contagion; in many others to negative this conclusion. 

How any competent observer concludes that leprosy is non- 
contagious in these islands is to me only accountable by presuming 
that previous views from extraneous sources have clouded his powers 
of observation. 

That leprosy did not prevail on these islands until many years 
after they were open to foreign intercourse, receives great confirma- 
tion in the fact that no true aboriginal word is in use for the name 
of the disease. I consider this a most significant illustration of the 
rapid spread of leprosy within a comparatively short era. I believe it 
perfectly safe to affirm that did leprosy exist amongst the ancient 
Hawaiians they would not call it, as the present race do, "Chinese 
sickness." Whatever defects the Hawaiian language may have, a 
very casual observation shows that it was in the highest degree, and 
is a language of minuteness and exactitude; for example, take the 
verb "to break," in the Hawaiian language it is exquisitely definite 
— to break, as glass, "naha;" to break, as rope, "moku;'' to break, 
as bone or stick, "haki ;" and it can scarcely be imagined that naming 
a slow progressive disease like leprosy was beyond the power of their 
intellect, and yet this is really what those who claim to trace a 
hereditary development of the disease ask us to do. The name "mai 
pake" may, no doubt, have originated on the interrogation by a na- 
tive of a Chinaman, "What is this disease?" The Chinaman would 
probably answer, "I do not know the Hawaiian word, but there are 
plenty of people sick with the disease in my country." Chinese 
with leprosy do not generally emigrate, though the disease may ap- 
pear after their arrival in the islands. As I have before mentioned, 
Mr. Stewart states the disease prevailed in the year 1823. What 
significance the absence of a true Hawaiian word for leprosy bears, 
rs such, that this very absence in itself is almost sufficient evidence 
to prove that leprosy has not reached its present development by 
hereditary influence only, and that a very strong, helping hand has 






CHINESE MOTHER AND BABE. 



Type of people who miss and lament the late Francis W. Damon; he 
spoke their language, and was their monitor and friend in need. 



372 THE PATH OF THE DESTROYER 

been offered by contagion, the period being too short for the in- 
fluence of heredity to show itself, if it is hereditary at all. 

I repeat, on no other grounds can the spread of leprosy be ex- 
plained in the Hawaiian Islands, than by regarding the disease as 
contagious. Were the habits of the people different to what they 
are, one might have some diffidence in arriving at this conclusion; 
here we have the best field of observation. In the carelessness of 
of the natives, in disease generally, their hospitality to the leper, 
and contempt of the disease, there is also present here in these 
islands a typical illustration of the ominous remark of Dr. Tilbury 
Fox — such remark generally being accepted as correct — "that it 
is in those places where leprosy is on the increase that the freest 
intermingling of the leprous and non-leprous parts of the community 
takes place." Could the opposite conclusion be arrived at, "that 
although in Hawaii free intercourse exists between the leprous and 
non-leprous," the disease does not spread? I say no. Any calm 
impartial observer must arrive, sooner or later, at the conclusion 
that the type of leprosy prevalent in these islands is contagious, 
whatever else may be related of it in other countries. Many 
cases, undoubtedly, present some striking pecularities, giving some 
credence to the view that the disease is non-contagious; but on a 
more minute scrutiny such cases can be explained on the principles 
of analogy, in certain respects like and similar, in other respects dif- 
ferent and dissimilar, and did such instances arise in the prevalence 
of a disease we have more accurate knowledge of, they would present 
but slight difficulties, these being one of the many peculiar traits of 
a specific disease like leprosy. 

I now wish to state, because I conclude leprosy is contagious, 
I think I am carrying conviction to the mind of any person, who 
may happen to read this report; my object is to state facts, and 
hence the truth must result. Did I wish to write a paper on the 
non-contagious nature of leprosy, I could do so at the expense of 
concealing prominent facts bearing on the view that it is contagious; 
on the other hand, did I wish to prove leprosy contagious, I might 
conceal many facts proving it non-contagious. To avoid any pros- 
pect of being charged with wholly treating leprosy in its con- 
tagious aspect, whatever cases bear on the non-contagious view, I 
will give as great prominence to, and assign to them their relative 
degree of importance. 

I now state my reasons for believing that leprosy is contagious. 

1. Heredity, as the sole agent in the propagation of the dis- 
ease, will not account for its rapid increase in these islands for the 
following reasons: 



THE PATH OF THE DESTROY ER 373 

(a) Sterility amongst the leprous is much more frequent than 
fertility. (Years 1884-87.) 

(b) The majority of the offspring of leper parents, or parent, 
are still-born, or die within a short period after birth. The chil- 
dren born at the Settlement, during the past fifteen months, amount 
to five, and two out of these alone are now alive. And again, it 
it doubtful if these two remaining infants will reach adolescence, 
and even then if they do, there is only a bare possibility of their 
developing leprosy. 

(c) Even allowing lepers to be fertile, is not the Hawaiian 
race notoriously unprolific? and shall I ask the question, whether a 
healthy parent is more likely to be fertile than the leper? If fertil- 
ity in a marked degree does not exist amongst the healthy, then it 
is hardly reasonable to conclude that it will exist to a greater degree 
amongst the leprous. 

Numerous children, the offspring of known lepers, have not 
developed the disease in their lives, although most probably alleged 
hereditary predisposition was present, but they never developed 
leprosy. 

That the influence of heredity might play an important role as 
the sole factor in the propagation of the disease, did the lepers in 
these islands only aggregate a few hundred since the disease was first 
definitely known, I quite admit; but when the number of lepers 
reaches into thousands, I certainly think that another source for its 
spread must be sought than in the influence of heredity. 

2. That, almost invariably, when no (?) hereditary history of 
the disease is obtainable, I can always elicit the facts "that contact 
with a leper for long or short periods had existed.'' I do not think 
the importance of this evidence can be sufficiently overrated, and it 
tends to difinitely prove leprosy spreads by direct contact, from in- 
dividual to individual. 

3. The evidence obtained from foreigners — victims of the dis- 
ease — and from the history of their own cases, lends strong support 
to the view that the disease is contagious. It is not rational, but 
absurd, to conclude that the foreigners who now have the disease, 
and those who have had the disease (now deceased) acquired it in 
their respective countries. How does the hereditary theory affect 
them? 

4. The history of Father Damien, who came here (Leper Settle- 
ment) in the year 1873, to exercise his calling as Catholic priest, 
and who has, within the past two years, been afflicted with symptoms 
suspeciously resembling those of leprosy — (since August, 1885, out- 



374 THE PATH OF THE DESTROYER 

ward manifestations of tubercular leprosy have appeared, placing the 
diagnosis beyond all doubt). His case will be discussed further on 
when dealing with the manner the "contagium" of leprosy enters 
the system. I may add, also, that Father Damien has always 
maintained that the disease was contagious; his continuous residence 
or thirteen years has afforded him plenty of facilities for giving this 
opinion on the matter. 

5. My own observations, from a physician's standpoint, will be 
stated hereafter. 

6. The opinions of experienced and reliable physicians in these 
islands. 

7. The failure to explain its appearance amongst clean families 
(foreign), known to have no tendency to the disease, otherwise than 
by regarding the disease in a contagious light. 

8. The contagious character of leprosy can be borne out in every 
particular by the attitude the Hawaiians adopt towards lepers. To> 
state briefly, "The lepers are welcomed in their midst with open 
arms." Were these conditions reversed, the state of affairs, socially 
fulfilling rigid seclusion and ostracism, then leprosy spreading to any 
extent, it would be necessary to seek other sources of spread than 
contagion supplies. 

Under these latter conditions, I do not deny that leprosy would 
exist, and there would also be strong evidence in favor of the disease 
being non-contagious. It is from this evidence also that we receive 
alleged facts applying to those countries where we have reports of 
the disease being non-contagious. 

I now wish to offer a few remarks to illustrate the progress of 
disease at Kalawao and Kalaupapa amongst the kokuas, both male 
and female ; these are cases that have been under my own observation, 
and have developed leprosy since my residence at the Settlement. 

In the month of January, 1885, I made a thorough medical 
inspection of all the kokuas residing at the Settlement ; the result was 
as follows: 

Total number male kokuas 91 

Total number female kokuas 87 

Total 178 

The male kokuas had mostly accompanied their wives, and the 
female their husbands. There were one or two cases where the 
father accompanied his son, and a mother her son or daughter, or 
aunt, nephew and niece. Be the relation what it may, all these 
healthy people were in contact with lepers continuously. 



THE PATH OF THE DESTROY ER 375 

In the month of August, 1885, I made another inspection. 

At the date of my writing this report (January 1, 1886), some 
twelve months after my first systematic inspection of the kokuas, 
the state of affairs is as follows: 

Number of male kokuas who have become lepers in the twelve 
months, February, 1885, to February, 1886, 5. Female kokuas who 
have become lepers during the same period, 12 — male 5, female 12; 
total 17. Total number male and female kokuas, therefore, are 17. 
Excess of female over male, 7. So that out of a total of 178 healthy 
people, in twelve months 9.5 per cent have developed leprosy. Then, 
at the same rate of progress, in twenty years all these people will be 
lepers. But this is not borne out absolutely, for many Hawaiians 
live here year after year, marry lepers again and again, and show no 
manifestations of the disease. Whatever may be said to the con- 
trary, I assert that a large majority of the Hawaiian race are posi- 
tively exempt from the disease under the greatest degree of exposure 
to infection — they are non-receptive or immune. 

NON-CONTAGION.— From what I have just written it is 
evident, I hold the opinion that, leprosy is not contagious to every- 
body. This is the case, and there is nothing remarkable in the state- 
ment. Did everybody who comes in contact with our well-known 
contagious and infectious diseases — small-pox, scarlet fever, measles, 
typhus, etc. — get each of them respectively, it would be a very dis- 
mal prospect for nurses and physicians, and other attendants. I 
simply assert that many persons have an immunity conferred on them. 
What confers this special immunity is now foreign to my purpose 
to enter upon, but the cases which go to prove leprosy non-conta- 
gious fall within this special sphere of immunity or non-receptivity. 

Wlien I see daily and hourly before my eyes a man who tells 
me he is perfectly well, looks well, and I conclude he is, after a 
medical inspection, and after these preliminaries I come to inquire 
into his history, and he states as follows: "I have had one, two, 
frequently three, and sometimes four leper wives, and my children 
have died from leprosy, and I have lived here ten years in contact 
with all the lepers" — after such a story as this it would be quite 
reasonable to conclude that leprosy is certainly not contagious to 
everybody — it is not a question of degree of contagion, but non- 
contagion and immunity. 

Again, w T hen a woman repeats in substance such a story as the 
following, and after all this contact and exposure, is to outward ap- 
pearance healthy, one would be justified in concluding that the dis- 
ease was non-contagious, certainly to this individual woman. 

To illustrate. — The washer-woman for the hospital at Kalawao 



376 THE PATH OF THE DESTROY ER 

has washed the soiled clothes of the worst cases, certainly many of 
them so, in the Settlement for the past seventeen years. Any one 
who has seen advanced cases of tubercular leprosy knows the con- 
dition this soiled linen will present ; nor is this her only contact with 
the disease; she has lepers living in her house, and, to crown all, 
her husbands, two in number, were lepers for years before they died ; 
and yet, in spite of all this contact, this said woman today is hale, 
hearty and plump, and as fine a specimen of womanhood as any in 
the islands; her age is now forty-six years. (This woman Kalehua 
later developed leprosy, in 1888.) 

But are these cases the rule? Certainly not. 

These cases number, at the Settlement: 

Males .: 26 

Females 22 

Total 48 

These forty-eight cases give an average of fifteen years each 
of close and intimate contact. That some will become lepers I am 
certain; that others will resist all infection I am also positively cer- 
tain. These are the accumulated Immunists. One woman has lived 
here nineteen years. 

I have already shown the number of kokuas who did develop 
leprosy last year, viz., seventeen. If the disease develops at the same 
rate, in three years time the contagious cases will have passed the 
non-contagious, taking the same figures; and yet these forty-eight are 
the accumulated veterans of the Settlement. 

ALLEGED, HEREDITARY PREDISPOSITION.— As an 
agent in causing the spread and perpetuation of leprosy, occupies no 
important position. In these islands, I will place its relative rank 
next to contagion, giving the latter the position of chief factor at 
work spreading the disease in this country. 

Having before stated, "that, in my opinion, leprosy was intro- 
duced here only since the advent of the foreigners," (?) hereditary 
predisposition has not had opportunity to prove sufficiently the extent 
of its power; that it can approach its ally, contagion, is not to be 
thought of, owing to the unproceativeness of the present Hawaiian 
race, and how hereditariness in leprosy should or could have been 
elevated to the first rank of propagator of the disease in these islands 
I am at a loss to understand. (Read Dr. Fitch's report.) 

Predisposition is a name applicable to very few diseases, the least 
exponent being found in leprosy, syphilis is quite erroneously placed 
under this heading. Tuberculosis somewhat falls under this heading. 




'GENUINE CHINA. 



378 THE PATH OF THE DESTROY ER 

I may here remark that no child born at. the Settlement since 
my period of residence has had manifestations outwardly of leprosy 
at birth. The causes, so far, that I have mentioned in connection 
with the spread of leprosy in the Hawaiian Islands are: First, con- 
tagion; second, possibly hereditary predisposition. The third cause 
to which I attach some importance, and which has (?) doubtfully 
spread the disease, is vaccination. 

I can bring forward no case personally, but I have hearsay evi- 
dence that after the operation of vaccination had been performed on 
several white children they manifested signs of leprosy, and finally 
developed the disease (but the evidence of so acquiring leprosy is far 
from conclusive). Evidence on this same point is put forward by 
Sir Ronald Martin, in India, and by Professor H. G. Piffard, of 
New York. The possibility of such an occurrence again taking 
place, "now that bovine virus only is used in the operation" by 
the medical officers of the Hawaiian government, is most improbable. 

The extent to which each of the following factors is responsible 
for spreading leprosy, these factors being contagion, heredity, and 
vaccination, are approximately as follows: 

Contagion, estimated at 90 per cent. 

? Heredity, estimated at 9 per cent. 

? Vaccination, estimated at 1 per cent. 

I have personal knowledge of the two first, which account for 
almost all cases. Some few cases not coming under either heading, 
I have placed under vaccination, as being the most feasible situation 
for them, as in the Hawaiian Islands I recognize no other agents at 
work, such as we hear of in Norway, India, etc. In these islands no 
such origin need be sought for, the disease being introduced. 

CONTAGIUM. — It is not my intention to enter at length on 
this subject, except in so far as it trenches on the domain of leprosy. 

By the "Contagium of Leprosy," I wish to convey "that sup- 
posed specific material in which the infective power ultimately resides." 

I believe that the "contagium" of leprosy enters the system by: 

1. Inoculation. (?) 

(a) At broken surfaces of the skin. 

(b) At broken surfaces, fissures or chaps, on external 
mucous surfaces. 

(c) Possibly by puncture of insects, or the presence 
of parasites, scabies, etc. 

(I held these crude ideas in the days of my youth. — Author.) 



THE PATH OF THE DESTROYER 379 

DIVISION II— INHALATION AND ALIMENTATION. 

— An act comparable to inoculation on an external surface takes 
place on an internal surface. 

1. Contagium particles or bacilli conveyed in the sputum and 
exhalations of the leper (especially in the advanced tubercular cases 
attended with severe ulceration), enter the mouth, are caught on the 
tonsils, or are carried into the bronchi and air cells. 

2. From eating with soiled fingers, bacilli may be swallowed, 
reach the stomach and the intestines, and later penetrate the texture 
of the intestinal mucous membrane, and thus effect as genuine an 
inoculation, with regard to the blood, as that which art or accident 
provides in other cases through the punctured skin. 

By the first means (inoculation) a few cases of leprosy are (?) 
propagated, but I do not think it is nearly so frequent as by alimen- 
tation. Under this latter heading I would place the case of Father 
Damien, whose history I briefly relate. 

Father Damien arrived at the Settlement in the year 1873, and 
has lived there continuously ever since. He is a Belgian, of good 
physique, and when he arrived, was thirty-three years of age. During 
all the period of his residence he has been daily and hourly in con- 
tact with lepers of various grades, many very severe. Until 1884 
he felt, fairly well. In that year pains in the left foot troubled him ; 
these continued to get worse, and, in the absence of any other signs, 
were attributed to rheumatism. Towards the end of the year 1884 
he consulted Dr. Arning (a physician who is making leprosy a special 
study), and to this gentleman must be given the credit of diagnosing 
the disease in its very early stage, as certainly not until six months 
afterwards did external manifestations of leprosy develop; the symp- 
toms pointing to deposit of leprous matter in the structures connected 
with the peroneal nerve in the flexure of the knee. In May, 1885, 
there were no striking changes in his face, except the forehead, when 
examined by Dr. Arning and myself. In August, 1885, a small 
leprous tubercle manifested itself on the lobe of the right ear, and 
from that date to the present, diminution and loss of eyebrows, in- 
filtration of the integument over the forehead and cheeks is slowly, 
but certainly, going on, so that the case of Father Damien is a con- 
firmed tubercular one, the symptoms and signs now present placing 
it in that class ; the Father is careless, has eaten repeatedly with lepers, 
has a leper cook also. 

I believe the majority of cases of leprosy at the Settlement, had 
they been rigidly watched, would fall in the same category as Father 
Damien's. Most cases of leprosy are recorded between the ages of 
twenty-five to forty years, so heredity is scarcely possible. 



380 THE PATH OF THE DESTROY ER 

I am also clearly of opinion that nodular leprosy is contagious at 
the beginning, and all through its course. 

Women are less liable than men to the disease, I believe, owing 
to ( ?) physiological causes peculiar to the sex; and, I explain, (the 
many cases related of certain women having two or three husbands, 
and although previously clean, falling victims to leprosy, the woman 
herself remaining unscathed) on these physiological grounds, which, 
when a certain age is reached and changes occur in the system — re- 
sulting in the cessation of menstruation — leprosy, which has been 
dormant, proceeds to show itself. The female may also possess, 
however, greater Immunity than the male, this may account for the 
disparity of prevalence in the sexes. 

One other point I wish to allude to, and that is, that I have not 
met with an intermixing of cases of tubercular and anaesthetic lep- 
rosy in the same family. The variety is tubercular alone, or it is 
anaesthetic alone. 

My opinion as to whether I think leprosy and syphilis are homo- 
logous is asked, and whether one disease has any connection with the 
other, or with tuberculosis. 

There is no homology between leprosy, tuberculosis and syphilis 
in my opinion, but there is an analogy. No other constitutional dis- 
eases are allied so closely as leprosy, tuberculosis and syphilis; but 
they are distinct diseases. Leprosy is sui generis, tuberculosis and 
syphilis are each sui generis. 

I affirm that any observer or physician who has studied syphilis 
carefully, will speedily see where the diseases agree, and where they 
no not. 

This report is very incomplete. I have written it, much against 
my own will, in the brief periods I could snatch from the busy 
hours of my professional work. To cover the vast field of leprosy 
requires more time and experience than I have had at my disposal. 

TREATMENT. — There are legions of alleged cures for lep- 
rosy, but most are of no value and cannot be relied on in any given 
case. 

In a few instances, in the early stages of the disease, it is 
possible to check the progress of leprosy by the persistent use of 
the following drugs: Calcium sulphide, sodium salicylate, quinine, 
and guaiacol carbonate. 

ARTHUR MOURITZ, 

Kalawao, Jan. 1, 1886. Physician. 



L 




'GENUINE CHINA." 



NONCONTAGIOUS 



REPORT OF DR. G. L. FITCH, 1884. 

To the Honorable the President and Members 
of the Board of Health: 

Gentlemen: In this, my quarterly report as medical officer in 
charge of the Leper Settlement, for the quarter ending September 
30th, 1884, I propose to thoroughly discuss the question of the con- 
tagious nature of leprosy, and its etiology. 

Before expressing any opinion of my own, it will be proper to 
give the views held by others who have made the study of the dis- 
ease elsewhere, and so I quote as follows from the "Report on 
Leprosy by the Royal College of Physicians." 

"The Committee having carefully considered the replies already 
received are of opinion that the weight and value of the evidence 
they furnish is very greatly in favor of the non-contagiousness of 
leprosy. 

"The Committee can only repeat the statement made in their 
former report to the College, that the replies already received con- 
tained no evidence which, in their opinion, justified any measure for 
the compulsory segregation of lepers." 

Acting on the advices already obtained, the Duke of Newcastle 
forthwith issued a circular to the governors of the Colonies express- 
ing his opinion "that any laws affecting the personal liberty of lepers 
ought to be repealed, and that in the meantime, if they shall not be 
repealed, any action of the executive government in enforcement of 
them, which is merely authorized, and not subjoined by the law, 
ought to cease." — Handbook of Treatment, Aitken. 

Doctors Danielssen and Boeck state, "that among the hundreds 
of lepers who we have seen daily, not a single instance has occurred 
of the disease spreading by contagion. We know many married 
persons, one of whom is leprous, cohabitating for years without the 
other becoming affected. At St. George's Hospital many of the at- 
tendants of the inmates have lived there for more than thirty years, 
and are quite free from any trace of the disease. As the result of our 
observations we have only to denv the contagiousness of leprosy." — 
Coll. Phys., Report, p. 4, XIX. ' 
Jamaica — 

"I am certain that it is in no way contagious, and that it is 



L 



THE PATH OF THE DESTROYER 383 

not transmissible by sexual intercourse. The evidence against the 
contagion of leprosy in all its forms is irrefragable." — Dr. Fiddes. 
Barb ado es — 

"I have noti met with any cases of contagion; none of those in 
attendance during the last nine years upon the inmates of the laz- 
aretto have contracted the disease, and I, after receiving a wound 
from a knife moistened with the fluids of an inmate, have escaped, 
although the wound was followed by great constitutional irritation 
and loss of the ringer. From what I have heard I do not believe 
it communicable by sexual intercourse." — Dr. Browne. 
Mytilene — 

"It is demonstrably not contagious. Dr. Bargilli practiced in- 
oculation in two instances, but without results." — Dr. Brunelli. 
Mauritius — 

"I know two instances where medical men have wounded them- 
selves in dissection, but without any bad results." — Dr. Powell. 
Crete — 

"There are 127 persons who have all lived together healthy 
among lepers for many years." — Dr. Brunelli. 
Benaveo — 

"All the reporters agree in stating that leprosy is not contagious, 
nor transmissible by sexual intercourse." — Dr. Dunbar. 
Nag pore — 

"During the nine years I have held charge of the Nagpore goal, 
with the daily average of 500 prisoners, all of whom freely inter- 
mingled, and some of whom when imprisoned were lepers, I have 
never known an instance of contagion. As far I could ascertain 
the disease does not seem transmissible by sexual intercourse." — Dr. 
Hende. 
New Brunswick— -Coll Phys. Report, pp. XLIII, XLIV, XLV. 

"I am thoroughly convinced that the disease in Tracadie is not 
contagious, and that it is not transmissible by sexual intercourse. All 
the cases I have reported prove its noncontagiousness. Leprous hus- 
bands have lived many years with their wives, and vice versa, with- 
out infecting each other. Children have been born of leprous moth- 
ers, and have been nursed and handled by patients in the Lazaretto 
in all stages of the disease, without manifesting any symptoms of the 
disease." — Dr. Bayard. 

"It does not seem to be transmissible by sexual intercourse." — 
Dr. Gordon. 

"I have never met with an instance of leprosy being communi- 
cated to a healthy person by contagion. On the contrary we have 



384 THE PATH OF THE DESTROYER 

a female, who, for the last six years has scrubbed the floors of the 
hospital, washed their clothes, ate, drank and slept with those affec- 
ted, and who, notwithstanding, exhibits no trace of malady, and at 
present enjoys good health. 

"Leprous husbands have, for many years, slept with their wives 
and families, and wives with their husbands, without contracting it. 
Children have been born of leprous mothers in the last stages of 
the disease and have been nursed by lepers, and have now attained 
adult ages without manifesting any symptoms of the disease. All 
of which proves it not to be transmissible by sexual intercourse." — 
Dr. Nicholson. 

"Several lepers have cohabited with their wives for years and 
no infection was communicated to them. In the case of a leprous 
man now in the hospital, the wife has continued free, although two 
of seven children which she has borne to him are afflicted with the 
disease." — Dr. Benson, Coll. Phys. Report, p. 4. 

William Aitken, M. D., etc., says in his recently issued "Hand- 
book of Treatment," p. 238, A.D. 1882: 

"LEPROSY; TRUE DEFINITION." 

"A constitutional noncontagious hereditary affection. There 
appears no more need (or just about the same) for restricting the 
liberty of lepers as for restricting the liberty of those afflicted with 
the gout." 

Under the heading: 

"A CASE OF INDIGENOUS LEPROSY," 

in the Medical Record of August 16th, 1884, W. H. Greddings, 
M. D., of Aiken, South Carolina, U. S. A., says: "Isolated cases 
of leprosy have been observed in Charlestown and its vicinity for 
many years, the present being the latest of a series of twenty that have 
been brought to my notice during the last twenty-five years. In none 
of these cases was the disease hereditary, although in one instance 
a mother and daughter were affected at the same time. In all 
these cases except the one just mentioned there was not the slightest 
evidence of contagion, nor has it ever been deemed necessary to 
isolate those affected with the disease. When well enough they 
walked about the streets of the city, attracting but little attention, 
as the people know from experience that in this country they run 
no risk of contracting the disease by coming in contact with those 
affected with it. 



L 




CHINESE-HAWAIIAN. 



386 THE PATH OF THE DESTROY ER 

"As isolated cases of leprosy have been observed on the coast of 
South Carolina for nearly forty years, without any apparent increase 
in the number of cases, it may be safely inferred that there is but 
little danger that the disease will ever become endemic in this section." 

A. Balmanno Squire, M. D., of London, says: "Greek Elephan- 
tiasis was formerly thought to be contagious. It has, however, long 
been satisfactorily ascertained that it is not so." — Reynold's System 
of Medicine, Vol. 3, p. 948, A.D. 1880. 

Thomas Hawkes Tanner, M. D., F.L.S., of London, says: 
"Elephantiasis Graecorum, or Elephantiasis Anaesthetica, or the East- 
ern Leprosy, is a terrible and dangerous constitutional disease, being 
endemic and affecting the poor and badly nourished in preference 
to the well-fed, while it is noncontagious, hereditary, and generally 
incurable." — Practice of Medicines, Tanner, p. 671. 

"That leprosy in Japan is not in the slightest degree contagious 
or infectious; that the idea to isolate lepers from other patients does 
not occur to anybody. In my own wards I have always had lepers 
between other patients, everybody knowing the nature of the dis- 
ease, but no one objects to the sleeping in the bed next to theirs. 
No disinfection is ever used. There is a native doctor in Tokio, in 
whose family the treatment of leprosy has been carried on as a 
specialty for at least three generations, he and his whole family live 
in the same house with his leper patients. For a hundred years, 
many, many thousands have been treated in that very same house in 
the center of the capital, inhabited by more than a million of people 
and never one case of contagion has happened." — Dr. Baelz, Prof, of 
Chemical Medicine at the University of Tokio, Japan (on board 
the steamer "City of Tokio, Pacific Ocean, September, 1884.) 

Dr. Baelz is one of the best and most favorably known physicians 
of the Orient. The above quotation is an extract of a letter from 
Dr. Baelz to Rev. S. C. Damon. 

A recent visitor at the Lazaretto in Tracadie found the Mother 
Superior of the Sisters of Charity, who have charge of the Lazaret- 
to, with her hands in the same basin of water with those of a leper, 
whose hands were covered with leprous ulcers. She, the Mother 
Superior, was cleansing the ulcers preparatory to dressing them. 
There are nine Sisters of Charity at that Lazaretto who have lived 
there for fifteen years, engaged as nurses and caring for lepers; none 
of the Sisters have contracted the disease. 

My authority for this statement is Rev. Father Leonor, Provin- 
cial of the Catholic Mission in these Islands. (Verbal communica- 
tion.) 



THE PATH OF THE DESTROYER 387 

The following quotation is from a recent newspaper article 
which, from other sources of information, (on the Etiology of Lep- 
rosy, by G. Armauer Hansen, Assistant Physician to the Leper Hos- 
pital at Bergen, Norway), I believe to be a true statement: 

"In a report given a few T days ago by the head physician of 
Norway it is shown that at the end of 1856 there were known in 
Norway 2,863 cases of leprosy, of whom then but 235 were treated 
in hospitals, and 2,628 in their houses. Since then there has been 
steadily more isolation, and thereby a steady diminishing of new 
cases, so that by the end of 1866 there were 2,704 cases, and of these 
795 were in hospitals, and 1,909 in their houses; a decrease of 159 
cases. By the end of 1876 there were 2,008 cases, showing a decrease 
of 696 cases. 

Since the decrease has been regular ; thus there were known in 
1877, 1,923 cases; in 1878, 1,835 cases; in 1880, 1,582 cases; of 
whom 617 were in hospitals, and 965 in their houses. Thus the 
decrease of this disease is from 2,863 cases in 1856 to 1,582 in 1880; 
in all 1,281, or 45 per cent." — Hawaiian Gazette, March 10th, 1883. 

Summing up this statement it will be seen that, beginning with 
1856, we find one case in twelve, or a little over, segregated, and 
2,628 different foci of contagion — according to those who believe in 
contagion — engaged in spreading the disease, and yet the disease be- 
gins to decrease, so that with a gradually increasing number of cases 
segregated — or rather varying in number, for in 1866 seven hundred 
and ninety-five were segregated, and in 1880 only six hundred and 
seventeen — by 1880 45 per cent of the disease disappears, but still 
about three-fifths of the cases are at large. It has been asserted, how- 
ever, that those who were living in their homes were carefully seg- 
regated. 

How to make these facts agree with the assertion of the advo- 
cates of contagion, in Hawaii, who so eagerly assure us that all the 
cases here originated from one imported case — a Chinaman, many 
years ago — and that the disease has spread from that one case, is a 
matter entirely beyond my comprehension. As we shall see further 
on, there is no evidence in favor of such a statement whatever. 

As is well seen, the evidence of observers in other lands, who 
have been brought into intimate contact with the disease, and have 
really investigated the matter, seems generally opposed to the doc- 
trine of contagion. Those like Dr. J. C. White, of Harvard Uni- 
versity, who has seen one case (Am. Journal Med. Sciences, p. 447, 
1882) or Dr. J. R. Tryon, of the U. S. Navy, who, during a visit 
of some weeks' duration here in Honolulu, visited the Kakaako leper 



388 THE PATH OF THE DESTROYER 

hospital three times — and in the American Journal Med. Sciences, 
April, 1883, is very sure of the contagious nature of the disease; and 
various observers elsewhere, who have examined the disease at a 
secure distance, are equally certain of it; but real, practical, earnest 
workers in the field, like Drs. Danielssen and Boeck of Norway, 
with their forty or more years of experience, say: "Among the hun- 
dreds of lepers whom we have seen daily, not a single instance has 
occurred of the disease spreading by contagion." 

"As the result of our observations we have only to deny the 
contagiousness of leprosy." 

And now let us turn to what we can find here in Hawaii to help 
us form a conclusion on the subject. 

In the March number, A. D. 1883, of the "Medical Bulletin," 
published in Philadelphia, I find this statement, by J. V. Shoemaker, 
A. M.,'M. D. 

"I am indebted to Professor Samuel D. Gross for a recent op- 
portunity of seeing and examining a young man suffering from lep- 
rosy. The patient was sent from Honolulu to Professor Gross by 
Drs. Hagan and Trousseau, gentlemen who are well known in the 
Sandwich Islands as expert practitioners of medicine. 

"The letter of introduction, and the description of the patient's 
condition, stated that they believed the case in question to be one of 
leprosy; and, as they regarded it noncontagious, they advised a trip 
to the States for a change and benefit to his general health, and 
wished him at the same time to have the best medical advice that 
this country could give." 

That Drs. Hagan and Trousseau did, at that time, believe that 
leprosy was noncontagious must have been the case, for it is entirely 
inconceivable that any man, and certainly any medical man, would 
send a person suffering with a disease that they believed contagious, 
to infect a healthy community ; yet how to reconcile this matter with 
the statement in the following card, published in the "Hawaiian 
Gazette," under date of May the 23rd, same year, is beyond my 
ability. 

"DOCTOR MATHES ENDORSED." 

"Editor Gazette: We have read with pleasure the article of 
Dr. G. L. Mathes in the Saturday press of May 15th, in which he 
ably sets forth the difference between syphilis and leprosy, and in 
which he gives the views of the great pathologists and eminent medi- 
cal investigators of the present day." 

"We cheerfully express our high appreciation of the article, and 



THE PATH OF THE DESTROY ER 389 

fully endorse the writer's views in regard to the non-identity of the 
two diseases. Moreover, with a knoweldge of the introduction and 
spread of leprosy among the people of these islands, we believe the 
disease to be eminently contagious/' 

"As to cure, we regret to say, that nothing is yet satisfactorily 
established, although modern scientific investigation in different coun- 
tries is tending to establish greater hopes in that direction." 

"Such being the case, we recognize segregation as the only means 
left us to rid the country of the disease. While we realize the se- 
verity of such a measure, and do most heartily regret the necessity of 
its enforcement, we cannot but feel that it is the only thing left us." 

"Better to amputate a diseased limb, than through a false sense 
of tenderness to allow it to remain and gangrene the whole body." 

"G. TROUSSEAU, M. D. 
"J. S. McGREW, M. D. 
"J. BRODIE, M. D. 
"N. B. EMERSON, M. D. 
"M. HAGAN, M. D." 

Many instances where foreigners, exclusive of Chinese, have 
lived with lepers I have seen personally. I have heard of a large 
number of other cases, and the result is the same. Not a single in- 
stance of contagion, or the development of the disease, has occurred 
among these cases, or in any of the cases that I have only heard of and 
not seen, among those who have been known to cohabit with lepers, 
except those which are doubtful. A white leper at the Settlement 
said he had had a multitude of native mistresses, and probably some 
ol them may have been lepers. Another white man at the Settlement 
said he had a native wife many years ago who had red spots on 
her, and large sores. This may or may not have been leprosy. Count- 
ing these two lepers just mentioned, I have had nineteen white people 
under my care who had leprosy. I have carefully questioned all but 
two of them as to whether they had lived or been on terms of in- 
timacy with lepers; all except the two whom I did not question, 
and the two whose statements I have already given, "denied any re- 
lations with lepers, and most of them deny ever seeing a case until 
they were declared lepers themselves/' The two whom I did not 
question were these: An aged Portuguese, with whom I could not 
converse, through inability to understand each other's language, and 
the first case I saw, which was shortly after I arrived in the king- 
dom, and before my attention was called to this matter. Of course, 
the entire nineteen may have been exposed many times to the dis- 




KING LUNALILO. 

Born January 31, 1835. Died February 3, 1874. 

Bequeathed the bulk of his fortune to found a home for his poor and 
needy subjects (see page 394). The benevolent and praiseworthy act of this 
Hawaiian king (only a brief period removed from so-called barbarism) ; is 
in striking contrast with the deeds of the dissolute, torture-loving, assassinat- 
ing and head-chopping specimens of kings, who have occupied European 
thrones in the not very remote past. 



L 



THE PATH OF THE DESTROY ER 391 

ease ; for I doubt much if one out of fifty among all the physicians of 
the world would recognize the first case of leprosy they should see 
unless it was a pronounced case. It is frequently a difficult matter 
to decide positively whether a person is a leper or not. There have 
been several cases here lately in which physicians, thoroughly familiar 
with the disease, were unable to agree or come to a definite con- 
clusion. 

Turning back to instances, on June 24th, A.D. 1882, while 
engaged in making a post-mortem examination of a boy who had 
died with leprosy the day previous, I scratched my wrist on my 
sleeve button, and did not discover the wound until it had been 
covered with blood from the boy's body for a full half hour. I have 
never experienced the slightest bodily inconvenience from the wound. 
Some months ago, I regret I cannot give the exact date, Dr. E. Arn- 
ing inoculated his finger while making a post-mortem examination 
of a leprous cadaver. I called his attention to a scratch on his finger, 
just as he was about to begin the operation, but he took no pre- 
cautions, and as a consequence his arm shortly afterwards swelled 
clear to his body, and he suffered severe constitutional disturbance, 
but he has not developed leprosy. 

Turning now to native cases. Kauuku, a mail-carrier on Molo- 
kai, had the palmer surface of the third finger of his left hand bitten 
out by a leper six years ago. He is not a leper. 

It is a well-known fact that leprosy exists in a large percentage 
of the native race. Estimating the entire native population of pure 
blood at something over 40,000 and total number of lepers at 1,800 
would give us four and a half per cent at any one time. I base this 
estimate on the fact that on October 9th, there were 723 lepers at 
Kalawao Settlement and 180 at Kakaako leper hospital, and from 
information from different portions of the kingdom, in answer to 
inquiries I have made. 

Drs. Danielssen and Boeck state : ''That the average duration 
of the tubercular form among the patients in the hospital at Bergen, 
from 1840 to 1847, was between nine and ten years, and of the 
anaesthetic form, among the same, was between eighteen and nineteen 
years."— Coll. Phys. Rep., p. LXV. 

September 30th, 1884, we had at Kakaako hospital 67 married 
males and 36 married females — that is, where either sex were, or had 
been married. One married couple were in the hospital, and of the 
rest, three of the males had had leprous wives, and one woman a 
leprous husband. 

No larger number of persons became lepers from inter-marriage 



392 



THE PATH OF THE DESTROY ER 



with lepers, than in the community at large, as these figures plainly 
show. 

Presenting the evidence in another form. The Leper Settlement 
at Kalawao was inaugurated A. D. 1866. Since which time up to 
the 1st of April this year, 2,864 persons have been consigned there 
as lepers. October 9th I made a careful census of the number of 
the children alive who were born at the Settlement, and where 
either or both parents were lepers before the birth of the child. 
The total number was twenty-six/ as follows: 



MALES 

Name Age 

Kalani 8 years 

Mahai (is a leper) 14 years 

Keoloewa (brother of Mahai) 11 years 

Kukelaile 4 years 

Kalaniuli 2 years 

Samuela 21 months 

Joe Kanaana 4 years 

Kunihi 3 years 

Kahema 2 months 

Keoni 9 years 

Damiana 9 years 

Keahimu 9 years 

Opupeli 10 years 

Joe 8 years 

Total, 14 boys. 

FEMALES 

Name Age 

Keneki 2 years 

Kahua 8 years 

Kamaka 4 years 

Likapeka 1 year 

Lilia - 13 years 

*Abikaila 9 years 

*Elikapeka 7 years 

Keoho 3 years 



Parents 



Mother 

Father 

Father 

Mother 

Both 

Mother 

Both 

Father 

Mother 

Father 

Mother 

Both 

Father 

Both 



Leper 
Leper 
Leper 
Leper 

Lepers 
Leper 

Lepers 
Leper 
Leper 
Leper 
Leper 

Lepers 
Leper 

Lepers 



Parents 

Mother Leper 

Mother Leper 

Both Lepers 

Father Leper 

Father Leper 

Father Leper 

Father Leper 

Both Lepers 



*Sisters of Mahai and Keoloewa. 



THE PATH OF THE DESTROYER 393 

Hoomanawanui 11 years Both Lepers 

Kalua \0y 2 years Both Lepers 

Leialoha (this girl is a leper) 9 years Both Lepers 

Mary 3 years Mother Leper 

Total, 12 girls. 

Of the total number, it will be seen that fourteen are above the 
age cf six years, or at or above the age when the permanent teeth 
begin to erupt, the earliest period of life when I have seen a case of 
leprosy developed, and before which I do not believe it ever appears; 
at least it must be seldom, as I have not seen a case younger among 
over two thousand lepers who have been under my charge. 

Two of the fourteen only are lepers, although, in addition to 
being born of leper parents, they have lived in the houses of lepers 
all their lives. 

In 1866 the easterly side of the point of land projecting out into 
the sea from the base of the cliff, on the northern side of Molokai, 
was duly set apart for a residence for persons afflicted with leprosy; 
and the disease having been by law declared contagious, all lepers 
were required to remove, or be removed, to this settlement. 

In 1873 the westerly side of the promontory was annexed to 
the settlement, but there remained several kuleanas, or homesteads, 
which were not purchased by the government, and the owners of these 
kuleanas remain on their lands to this day. 

With a number, at least, of these kuleanas, or owners, it has 
been the custom to take lepers into their families to reside, so as to 
share the rations of food provided by the government for the sick; 
and, where this has not been the custom, they have freely com- 
mingled with their leprous neighbors, and, in two instances, have 
intermarried with lepers. 

The total number originally of these kamaainas was thirty- 
eight. One of them developed leprosy before the place was annexed 
to the settlement, but none of the rest have become so since the 
annexation, a period of eleven years. 

Now let us proceed to sum up the evidence. 

First — The Royal College of Physicians, a body of medical 
men representing the highest medical intelligence of the age, deny 
the contagious nature of the disease, after a study of it lasting through 
a period of several years. 

Second — Acting on the advice of this body of medical men, the 
secretary for the English colonies instructs the governors of the colo- 
nies "that any laws affecting the personal liberty of lepers ought to 




THE LUNALILO HOME. 

King Lunalilo's token of love for his aged, infirm and homeless subjects. 
Opened March 31, 1883. 



THE PATH OF THE DESTROYER 3Q5 

be repealed; and that, in the meantime, if they shall not be repealed, 
any action of the executive government in the enforcement of them, 
which is merely authorized, and not enjoined by the law, ought to 
cease." 

The results of such action, if the disease were contagious, would 
seem most certainly to be a vast increase of the malady. Let us see 
whether this be so or not. 

In the Chronicle of the London Missionary Society, March, 
1884, I find the following, by Rev. James Kennedy, M. A.: "Lepers 
are found in all parts of India, not in such numbers as to be an 
appreciative portion of the population, but in such numbers as to be 
well known. They are regarded by the Hindoos as objects of divine 
displeasure, not on account of wickedness in the present life, but on 
account of wickedness committed by them in a former birth. While 
thus regarded, they are not excluded from society, as was the case 
with the Jews, and is still the rule in some parts of the world. They 
are allowed to move about, and to ask alms of those they meet. At 
Benares I have sometimes seen them sitting on a native bedstead 
with persons who, if they did not touch them, showed at least no 
dread of their immediate neighborhood." * * * "While Ku- 
maun was under native rule lepers were buried alive, their nearest 
relatives heaping earth on them ; but since the establishment of British 
rule, in 1815, this atrocious custom, as well as other customs equally 
inhuman, has been suppressed." P. 89. 

Rev. J. H. Bruce, of Satara, India, writes: "I cannot find that 
there are any government laws whatever on the subject of leprosy. 
There are certainly no laws of segregation, and lepers are found 
everywhere in their homes and villages. There are no restrictions 
in regard to their marriage — there could hardly be any in this land 
of infant marriages. In the case of adults, "the non-leprous party 
would shrink from marrying a leper." When, however, one of the 
parties became a leper after marriage, there would not always, and 
perhaps not generally, be a separation of husband and wife. * * * 
We have had in our house for years a child nurse, who is the widow 
of a leper. * * * You ask how Vishompunt could preach and 
visit if he were a leper? The fact of his being a leper was well 
known, and never in any way concealed, yet he continued his pas- 
toral work until within a week of his death." Letter to Rev. C. M. 
Hyde, D. D., published in Hawaiian Gazette, May 14th, 1884. 

"I find, from the censuses of the following Provinces of 1871 
and 1872, comprising nearly the whole of India, viz., Bengal, 
Madras, Bombav, the Central Provinces, the Northwest Provinces, 



396 THE PATH OF THE DESTROYER 

Oudh, Coorg and Mysore, that the total number of lepers then 
enumerated was 99,639, or 1 in 1,864 of the population; but, as I 
have already stated about 1 in 1,500, or 120,000, would be, I believe, 
nearer the truth."— P. 42, "Leprosy." W. Munro, M. D., C. M. 
Manchester, 1879. 

Third — Segregation, except in so far as it prevents hereditary 
transmission of the disease, has absolutely no effect toward checking it. 

(a) In India, under native rule, up to 1815, lepers were buried 
alive, but still the disease persisted; while under English rule, with 
no compulsory segregation, we find, at the most, only one in 1,500 
persons a leper. 

(b) In Norway it begins to decrease with only one in twelve 
and a fraction segregated; and by the time two in five are segre- 
gated, 45 per cent of the disease has disappeared in the short space 
of twenty-five years. 

(c) In South Carolina the disease does not increase in forty 
years without segregation. 

(d) In Hawaii, where a larger percentage of cases are segre- 
gated than Norway, the disease for many years increased. Although 
at no time within the last fifty years have less than one-half the 
cases of leprosy in this kingdom been segregated, and for the last two 
years a still larger proportion. 

(e) Heredity plays but little figure in the spread of the disease, 
because we find that after sending more than 2,800 lepers, during a 
period of eighteen years, to Kalawao Leper Settlement, there are only 
twenty-six children alive, and only two of these children are lepers. 

While, however, this disease is, as I believe, absolutely non- 
contagious, that fact does not do away, as far as these islands are 
concerned, with the need of strict segregation. * * * But carry- 
ing out the law to the letter presents almost insuperable obstacles, 
which no one who has not been in a position to know from personal 
experience can fully comprehend. 

Fourth — Leprosy is an absolutely non-contagious and non- 
communicable disease from a leper to any other person by any pos- 
sible combination of circumstances except by heredity. 

(a) We find that seven inoculations, namely, the two cases inoc- 
ulated by Dr. Bargillo, the two cases mentioned by Dr. Powell of 
medical men wounded in dissecting leprous cadavers, Dr. E. Arning, 
and myself, wounded in the same way, and also Dr. Browne, who 
lost his finger as the result of inoculation, and no leprosy results. 
These seven cases mentioned do not, as is seen, include Kauuku, the 
mail carrier on Molokai, who had his finger badly bitten by a leper. 



THE PATH OF THE DESTROYER 397 

(b) Husbands who have leprous wives, and wives who have 
leprous husbands, as is seen in the 103 cases of married persons at 
Kakaako Hospital, do not contract the disease in a larger proportion 
of cases than among the community at large. 

(c) Women conceive and bear children by leprous husbands, 
and in some cases, first by a leper, and the children also develop lep- 
rosy, and yet the wife and mother escapes, and, as found afterward, 
capable of bearing healthy children by a healthy man. 

(d) Food cooked by lepers and eaten by non-lepers, the clotihng 
of non-lepers washed by lepers, and the blood and pus-saturated gar- 
ments of lepers laundered by non-lepers, eating, sleeping, drinking 
with lepers for years fails to reproduce it. 

Fifth — Those who are constantly exposed to the disease for years, 
as physicians, nurses and attendants on lepers, seem to invariably 
escape; certainly the proportion is not larger, if as large, as among 
the population of countries where leprosy is endemic. In fact, I can 
find only one case in medical history where a physician contracted it, 
and no nurses are mentioned as having it. 

For years it has been the custom here, among those advocating 
contagion, to offer what to them seemed apparently an unanswerable 
argument in favor of contagion. 

"Thirty or more years ago there were only a few cases here, 
and now there are hundreds; it must have spread from contagion. 
There is no other way to account for it." 

In A. D. 1856, when I first went to a mining camp in Cali- 
fornia, malarial troubles were a thing unknown, but in less than ten 
years "fever ague" was as common, or more so, there than leprosy is 
here now. Yet no one thought of contagion, although not infre- 
quently one after another would be taken down with the disease in 
the same place. 

Very frequently a man would be taken sick with the disease, 
and shortly after the wife, or vice versa, which, according to some 
acute observers who write on leprosy, is a sure proof of contagion ; 
but probably these people would not observe any sign of contagion 
under the same circumstances with malarial disease ; but I am utterly 
unable to see why it is not as much a sign of contagion in one case 
as in the other. 

As I have before stated, nineteen foreigners, exclusive of Chi- 
nese, have come under my care, having the disease, during my four 
years' residence in the kingdom. 

All these persons with one exception were adult males, with no 
history in any instance of hereditary taint. 



398 THE PATH OF THE DESTROYER 

How have these parties contracted the disease? 
This brings up the question of etiology. 

GEO. L. FITCH, M. D. 

The late Dr. G. L. Fitch, subsequent to his leaving the service 
of the Board of Health, made some experiments on his Hawaiian 
patients. With blood and serum obtained from scarified leprous 
nodules he inoculated some thirty males and females on the upper 
arm, similar to the usual method pursued in vaccination. 

The Doctor claimed that all these cases had syphilis, and he pro- 
posed to demonstrate that leprosy could not be successfully inocu- 
lated, because it is or was modified syphilis in a fourth stage, hence 
not inoculable nor contagious. Whether this assumption is correct 
or not, it however furnished to my mind fresh evidence of the non- 
inoculability of leprosy, for no development of that disease took place 
in any of these inoculated people within the four years subsequent to 
the performance of the operation. 

On a previous page of this monograph I have stated, while Dr, 
Fitch in Hawaii apparently promulgated new and novel views regard- 
ing leprosy, they were really not new; for as far back as the year 
1858 Dr. Danielssen of Norway had recorded his work and experi- 
ences on the syphilization of lepers, and its failure to alter or modify 
the general features of leprosy. What was old history, and well 
authenticated in Norway, was introduced and palmed off on Hawaii 
in the year 1881 as a new and previously unknown discovery. 

DR. RICHARD OLIVER. 

The late Dr. Richard Oliver held the office of resident physician 
at the leper settlement for ten years, 1892-1902. 

At the date of his death, August 12, 1902, the Doctor had 
lesided over thirty years in the Islands, and had had a very long and 
comprehensive experience with leprosy on the Island of Hawaii, some 
twenty years. The last ten years of his life, spent at the leper set- 
tlement, added largely to his knowledge of the disease. The copious 
notes, memoranda and other data on leprosy, which he had accumu- 
lated, he had intended to publish; but his last illness and subsequent 
death prevented this. Whatever books and papers the Doctor pos- 
sessed were speedily lost or destroyed soon after his death, which 
occurred three months after he had resigned his office at the Leper 
Settlement. 

Dr. Oliver's long contact with leprosy in Kona and Kau, and 



L 



THE PATH OF THE DESTROYER 399 

later at Molokai, where he did some experimental work, had con- 
vinced him that the inoculability of leprosy had yet to be proven. He 
was, however, an advocate of non-contagion, but my persistent and 
insidious proselytising won him over to the fold of contagion. 

The Doctor had received his medical education at the medical 
school of Saint Bartholomew's Hospital, which is situated in the 
heart of the old or true City of London. It is one of the most 
ancient seats of hospital and monastic work; the resident monks were 
the hospitallers. 

This hospital was founded by Rayere, a physician and monk, in 
the year 1102 A. D., eight hundred and fourteen years ago. 

It enclosed a large and famous leper hospital within its bounda- 
ries, where some 37,000 lepers were cared for between the years 1150 
and 1390, a period of two hundred and forty years. 

About the year 1347 six thousand cases of black death, or spotted 
typhus, died within the portals of the hospital proper; and again, in 
the year 1665, the bubonic plague filled the hospital with some 
10,700 cases, and over 90 per cent of these victims died. 




J 



NODULAR LEPROSY (Mild 

Early Stage. 
The Eestrover at work. 




NODULAR LEPROSY (Medium). 

Advancing. 
Medicines and serums fail to check the Destroyer. 





i 



NODULAR LEPROSY (Severe), 

Very Advanced. 
The Destroyer actively at work. 




PIGMENT DEPOSIT IN SKIN OF FEMALE LEPER. 




LEPROUS MACULATION AND INFILTRATION OF THE DERMAL 
TISSUES OF THE DORSUM. 



■>;? 




NODULAR LEPROSY. 
The Leper Ear. 




DUAL OR MIXED LEPROSY. 



1 



I 




DUAL OR MIXED LEPROSY. 




NEURAL LEPROSY OF THE HAND. 
The "Main en Griffe" or Claw-Hand. 




NEURAL LEPROSY OF FOOT. 

Pressure Ulcers Due to Trophic Nerve Lesions. 




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APPENDIX. 

PART V. 

LAWS RELATING TO LEPROSY. 



VISITORS REQUIRE PERMITS. 

No person, not being a leper, shall be allowed to visit or remain 
upon any land, place, or inclosure set apart by the Board of Health 
for the isolation and confinement of lepers without the written per- 
mission of the President of the Board, or some officer authorized 
thereto by the Board of Health, under any circumstances whatever, 
and any person found upon such land, place, or inclosure without a 
written permission shall, upon conviction thereof, before any district 
magistrate, be fined in a sum not less than ten nor more than one 
hundred dollars for such offense, and in default of payment, to be 
imprisoned at hard labor until the fine and costs of court are dis- 
charged in due course of law. 

BOARD MAY MAKE RULES AND REGULATIONS. 

It shall be lawful for the Board of Health, through its Presi- 
dent, to make and promulgate such rules as may be from time to time 
necessary for the government and control of the lepers placed under 
its charge, and such rules and regulations shall have the same force 
and effect as a statute law of the Territory: Provided, always, that 
the sanction of the governor be given thereto, and that they be pub- 
lished in two newspapers, published in Honolulu, one in the Hawaiian, 
the other in the English language. 

The Board of Health is hereby authorized to permit any person 
to engage in the treatment of lepers or of persons supposed to have 
leprosy. Such permits shall be under such conditions and regulations 
as the Board shall prescribe, and be revocable at the pleasure of the 
Board. 

SEGREGATION OF LEPERS. 

HARBORING A LEPER A MISDEMEANOR. 

Whoever shall knowingly detain or harbor upon premises sub- 
ject to his control, or shall in any manner conceal or secrete, or assist 
in concealing or secreting any person afflicted with leprosy, with the 
intent that such person be not discovered by or delivered to the Board 
of Health or its agents, or who shall support or assist in supporting 
any person having leprosy living in concealment, shall be deemed 
guilty of a misdemeanor, and shall on conviction thereof before any 
district magistrate, be liable to a fine of not more than one hundred 
dollars. 



404 THE PATH OF THE DESTROYER 

DUTY OF POLICE OFFICERS. 

It shall be the duty of every police officer or deputy sheriff, having 
reason to believe that any person within his district is afflicted with 
leprosy, to report the same forthwith to the agent of the Board of 
Health in such district, if any, otherwise to the nearest agent of the 
Board of Health. 

Any police officer or deputy sheriff who shall wilfully fail to 
comply with the provisions of the previous section shall be deemed 
guilty of a misdemeanor, and, upon conviction thereof before any 
district magistrate, shall be fined in a sum not less than ten dollars 
nor more than two hundred dollars, and shall be dismissed from office. 

KOKUAS ARE SUBJECT TO THE BOARD. 

Voluntary helpers or kokuas living with lepers segregated by the 
Board of Health may be by such Board declared infected with the 
disease of leprosy, and capable of communicating the same to others. 
All such kokuas are hereby placed under control of the Board of 
Health, and may be prevented by it from intermingling with those 
free from the disease. 

The Board of Health, with the consent of the governor, is 
empowered to make and promulgate such rules and regulations in 
regard to such helpers or kokuas for their care, discipline and mainte- 
nance as may be deemed necessary, which rules and regulations shall 
have the force and effect of law when promulgated. 

DUTIES OF KOKUAS. 

Every kokua who has heretofore received permission, or who 
may hereafter get permission to go to the Leper Settlement, according 
to law, shall perform the duties of kokuas to their leper friends, as 
provided in the following sections, and in no other way. 

The duties to be performed by the kokuas of the lepers shall be, 
that each kokua must take care of the leper or lepers that he went 
there to assist, and to go and get and prepare in a suitable manner all 
food and other supplies that are furnished by the government to the 
lepers, and attend to the clothing and other things that would con- 
tribute to the comfort of the lepers whose kokuas they are. And 
said kokuas shall also perform such labor and service as may be 
required by the Board of Health, when requested to do so by the 
superintendent of the Leper Settlement, for which services they shall 
be paid such wages as are deemed fair and just by the Board of 
Health, such wages to be not less than fifty cents per diem. And any 



. 



THE PATH OF THE DESTROYER 405 

kokuas refusing to perform such labor, as above stated, or who shall 
violate any rule or regulation of the Board of Health, shall be liable 
on conviction before a district magistrate to expulsion from the 
Settlement. 

CARRYING LEPERS. 

No steam-coasting vessel licensed to carry passengers and engage 
in the regular performance of that business, according to the pub- 
lished schedules of sailing times, and whose net tonnage exceeds two 
hundred and fifty tons, shall be compelled, while so engaged, to 
carry to or from any port or place in the Territory of Hawaii any 
leper, or any person suffering from any contagious or infectious 
disease. 

The master or owner of any such vessel knowingly violating the 
provisions of this act shall be guilty of a misdemeanor, and upon con- 
viction before any district magistrate shall be fined in a sum not to 
exceed two hundred dollars. 

Any person violating the provisions of this act shall be deemed 
guilty of a misdemeanor, and upon conviction thereof before any 
district magistrate shall be fined in a sum not to exceed two hundred 
dollars. 

ACQUISITION OF LAND. 

The Superintendent of Public Works is hereby empowered tc 
purchase all lands, the title to which is now held and owned by pri- 
vate persons within the precincts of the government reservation used 
for the Leper Settlement at Molokai. 

In every case where no agreement about the price on such lands 
can be made between the Superintendent of Public Works and the 
owners, there shall be appointed three disinterested persons who shall 
appraise the value of said lands and improvements, one of whom shall 
be appointed by the Superintendent of Public Works, one by the 
owner of the land, and the two thus appointed shall choose the third 
member, and such appraisement shall be binding upon the parties, 
unless the party who may be dissatisfied with such appraisement shall, 
within twenty days after notice of such appraisement, appeal there- 
from. 

The appeal shall be taken to the Supreme Court, sitting in banco, 
who shall decide the question upon the testimony presented before 
the appraisers, and no new evidence shall be allowed to be given on 
such appeal. The Supreme Court may, upon such appeal, approve, 
reverse, or modify the appraisement ; and such decision of the Supreme 



406 THE PATH OF THE DESTROY ER 

Court shall be final and binding upon the parties to the controversy, 
and the owner of said land shall not be subjected to the payment of 
the costs of such appeal. 

The owner of such lands shall deliver possession of the same 
to the officers in charge of the Leper Settlement within sixty days, 
after the appraisement becomes final, and the Superintendent of 
Public Works shall forthwith, after such delivery, pay to the owner 
the sum fixed by the appraisement or decision ; and upon such pay- 
ment the title to said lands shall become and remain vested in the 
government. 

A copy of the appraisement or decision, duly certified with the 
certificate of the Superintendent of Public Works, of the payment 
or tender of the sum appraised or decreed, duly acknowledged by 
said Superintendent, shall be recorded and be deemed sufficient record 
evidence of the change of title. 

ACQUIRING LAND ON MOLOKAI FOR SEGREGATION. 

The Superintendent of Public Works is hereby authorized and 
empowered to enter upon and take possession of and hold for the use 
of the government, such land, real estate, and property wheresoever 
situated on the Island of Molokai, in the Territory of Hawaii, as 
may be required by the Board of Health for the segregation and con- 
finement of lepers, or for other purposes of the Board of Health. 

Whenever the Board of Health may require any parcel of land 
or property on the Island of Molokai for such purposes, the Presi- 
dent of the Board shall so inform the Superintendent of Public 
Works in writing, stating the location and area of such land or prop- 
erty so far as may be known to him, and the purpose for which the 
same is required, with a request that the same be acquired by the 
government. If upon receipt of such request and information the 
said superintendent shall deem the same to be reasonable and proper, 
he shall, after first giving thirty days' written notice to the occupants 
of such land or property, take possession of the same for the use of 
the government. Provided, however, that if such land or property 
is not actually occupied by any person, the said superintendent may 
take immediate possession of the same. 

COMPENSATION TO OWNERS. 

Whenever the Superintendent of Public Works shall proceed to 
take possession of any land or property under the provisions of this 
act, he shall first endeavor to agree with the owners (if known to 



L 



THE PATH OF THE DESTROYER 407 

him) of such land or property taken, or to compromise with them, 
and in case of failure to agree with them, he shall appoint three com- 
petent and disinterested persons to act as commissioners and determine 
such compensation. 

NOTICE TO OWNERS. 

The commissioners so appointed shall give notice to the owners, 
if known to them and resident within the Territory of Hawaii, whose 
property has been taken or is proposed to be taken. If the owners of 
such land or property be known or cannot be served by reason of 
non-residence or other cause, then a notice posted in a conspicuous 
place on the land or property, or left at the owner's, occupant's, ten- 
ant's, or agent's residence, shall be deemed sufficient notice. Such 
notice may be in general terms and addressed to all persons interested. 

APPRAISEMENT OF LAND. 

Such notice shall describe the land or property taken or proposed 
to be taken, and state the time and place at which the commissioners 
will meet to hear the claimants, and take evidence as to the amount 
of compensation to which they are entitled. At every such meeting 
the commissioners shall take such testimony as they deem necessary, 
and they or a majority of them shall determine upon the proper com- 
pensation to be made. The decision arrived at by the commis- 
sioners shall be final and binding unless an appeal is taken as herein- 
after provided. The commissioners shall have power to administer 
oaths, subpoena witnesses, and grant continuances in like manner as 
district magistrates. 

The commissioners, or a majority of them, shall make, sub- 
scribe, and file with the Superintendent of Public Works, within such 
reasonable time as shall be fixed upon by said Superintendent, a cer- 
tificate of their findings and appraisement, in which the land or prop- 
erty so valued shall be described with convenient accuracy and 
certainty. 

Upon the filing of the certificate as provided in the preceding 
section, the Superintendent of Public Works is hereby authorized to 
pay to the person or persons named in the certificate, the several 
amounts determined upon by the commissioners, out of any appro- 
priation available for the purpose. Provided, always, that either 
party feeling aggrieved by the decision of the commissioners may 
appeal to the Circuit Court of the First Judicial Circuit. 

All appeals must be taken within twenty days after the date of 



408 THE PATH OF THE DESTROYER 

the filing of the certificate with the Superintendent of Public Works, 
by filing with the commissioners a written notice of the appeal, and 
filing with the Clerk of the Judiciary Department a bond in the sum 
of fifty dollars, conditioned to secure payment of future costs. Pro- 
vided, however, that fifty dollars in money may be deposited in lieu 
of a bond. 

Such appeal shall not prevent the superintendent from retaining 
or taking possession of the land or property mentioned or valued in 
the certificate. 

A copy of the final appraisement or decision, duly certified by 
the Superintendent of Public Works under the seal of his office, shall 
be recorded in the office of the Registrar of Conveyances, and shall 
operate as a deed of conveyance in fee simple from the owners of the 
land or property to the Territory of Hawaii. 

The Superintendent of Public Works shall, on receiving the 
certificate of appraisement, pay to the commissioners such reasonable 
compensation for their services as he shall determine upon, and he 
shall have power to fill any vacancy in their number caused by death 
or otherwise. 

EXEMPTION FROM PERSONAL TAXES. 

All lepers residing at Kalawao and Kalaupapa, on the Island of 
Molokai, are hereby declared exempt from any payment of any per- 
sonal tax, or taxes upon personal property, owned and kept by them at 
Kalawao and Kalaupapa, Molokai. 

AGAINST TRESPASSING AT LEPER STATIONS. 

Lands at Kalaupapa, Waikolu and Kalawao, on the windward 
side of the Island of Molokai, have been and are hereby set apart by 
the Board of Health for the isolation and confinement of lepers ; and 
all masters of vessels are prohibited from touching, receiving, or 
delivering passengers or freight at either of the above named places,, 
except by special permission of the Board of Health or its agents. 

Lands at Puuhale, Kalihi, Oahu, have been enclosed and are 
hereby set apart by the Board of Health for a leper receiving station,, 
and all parties are hereby prohibited from entering said enclosed 
premises without permission of the Board of Health or its agents. 

EXAMINATION OF LEPERS. 

Whereas, under Sections 1122, 1126, 1127 and 1129 of the 
Revised Laws of the Territory of Hawaii, authority is given the 
Board of Health, 



THE PATH OF THE DESTROYER 409 

Therefore, Be It Resolved, That all previous rules for the 
examination of lepers are hereby repealed; and further Resolved, That 
all future examinations of any person or persons for the determina- 
tion as to whether or not they are affected with the disease leprosy, 
shall be conducted under the following rules : 

First — The Board of Examining Physicians shall consist of five 
physicians, appointed by the Board of Health, one of w T hom shall be 
the bacteriologist of the Board of Health and another of whom be 
skilled in the use of the microscope for the discovery of the bacilli 
of leprosy, and be designated as the assistant bacteriologist. 

Second — The bacteriologist of the Board of Health shall 
promptly make a preliminary examination of each person coming vol- 
untarily or otherwise under the control of the Board of Health under 
the suspicion of or being alleged a leper. At said preliminary exam- 
ination should the bacteriologist fail to find the bacilli of leprosy 
present within such person, then said person shall be immediately dis- 
charged and returned to his home at the expense of the Board of 
Health. Should the bacilli of leprosy be found present within such 
person, said person shall be held for examiantion at the next meeting 
of the full Board of Examining Physicians. 

Third — Each person so held shall be given one week's notice of 
the meeting of the Board of Examining Physicians. 

Fourth — Each person so held shall have the privilege of being 
represented at said meeting of the Board of Examining Physicians by 
a physician selected and employed by such person. Should said physi- 
cian object to the decision of the Board of Examining Physicians he 
shall do so in writing, stating his reasons therefor. Upon receipt of 
such written objection, the president of the Board of Health shall 
direct both bacteriologists of the Board of Examining Physicians to 
make a re-examination of such person, at which re-examination said 
physician may be present. They shall report to the president of the 
Board their findings, and he shall transmit a copy of same to the 
physician representing such person. 

Should both bacteriologists find the bacilli of leprosy to be pres- 
ent within such person the decree of the Board of Examiners shall be 
final ; otherwise such person shall be treated as a "suspect" and 
shall be required to report for further examination as the Board may 
direct. 

Fifth — All persons examined by the Board of Examining Physi- 
cians shall be placed in one of the following classifications, viz: Not 
a Leper; Suspect; Leper. 



410 THE PATH OF THE DESTROY ER 

If in the opinion of three or more of the Examiners any person 
examined is a "suspect" he or she shall be so declared. 

If in the opinion of three only of the examiners any person is a 
leper, he or she shall be classed as a "Suspect" with the condition 
that he or she report to the Examining Board as it may direct for 
re-examination. 

If in the opinion of four or more of the examiners any person 
examined is a "Leper" he or she shall be so declared. 

RULES AND REGULATIONS FOR LEPERS AND KOKUAS 
AT THE LEPER SETTLEMENT ON MOLOKAI. 

Section 1. All persons and kokuas are required to live in an 
orderly and peaceable manner, and to respect the laws of the Terri- 
tory of Hawaii, as well as the rules and regulations of the Board of 
Health, and lawful orders of the superintendent. 

NOT TO LEAVE SETTLEMENT 

Section 2. Lepers shall not leave the Settlement except on an 
order from the Board of Health. 

Section 3. Lepers shall not scale or climb up the palis without 
a permit from the superintendent, and then not beyond the limits 
prescribed by the superintendent. 

Section 4. Lepers and kokuas shall not enter or live on the 
kuleanas, or in the houses owned by the kamaainas at Kalaupapa or 
other portions of the Settlement. 

MUST KEEP THE HOUSES CLEAN. 

Section 5. All able-bodied lepers are required to keep the sur- 
roundings of their houses clean, and to whitewash or cause to be 
whitewashed the houses in which they live, which are not painted 
with oil paints inside and outside, twice a year, at intervals of six 
months, for which lime and brushes will be furnished. On failure 
of lepers to comply with this rule, without showing good cause, the 
work will be done for them at their expense. 

NOISES AT NIGHT FORBIDDEN. 

Section 6. Noises after 9 o'clork in the evening and disturbanses 
of the quiet of the night are forbidden. 

Section 7. The inmates of the Homes or hospitals shall con- 
form to the rules and regulations made by those in charge of the said 
Homes and hospitals, under penalty of dismissal from the same. 



THE PATH OF THE DESTROYER 411 

MAY BUILD HOUSES. 

Section 8. Lepers are permitted to build houses for their own 
use, and to select building sites, subject to approval of the superinten- 
dent of the Settlement; provided, however, that, if at any time the 
Board of Health desires any such land for any purpose, the Board 
shall have the right to remove any house thereon to another site. All 
expenses of moving shall be borne by the Board, and the Board shall 
pay to the owner of the house all actual damage caused him by reason 
of such removing. 

Section 9. They may sell, or give away, or devise by will such 
houses, but only for the use and occupation of other lepers, and with 
the knowledge and approval of the Board of Health. 

Section 10. No leper shall be permitted to build or own more 
than one dwelling house. 

PROPERTY LEFT BY LEPERS. 

Section 11. Property left by lepers who have died without 
leaving a will, and who have no legal heirs at the Settlement, will be 
sold at public auction, and the proceeds after deducting the lawful 
expenses will be remitted to the president of the Board of Health, 
for the benefit of the legal heirs of the deceased, and if after due ad- 
vertisement in an English and Hawaiian newspaper no lawful claim- 
ant shall appear, such proceeds, after deducting the expense of the 
advertising, shall be turned over into the public treasury as govern- 
ment realizations. 

W!ILLS MUST BE WRITTEN. 

Section 12. Lepers may leave their personal property and effects 
at the Settlement by will, but only by a written will signed in the 
presence of not less than two witnesses, one of whom shall be the 
superintendent of the Leper Settlement, or other officer authorized 
by the superintendent. 

CLAIMS FOR SERVICES TO LEPERS. 

Section 13. After the death of a leper no claim for services ren- 
dered him will be allowed, unless proofs are produced, that the de- 
ceased in his lifetime verbally acknowledged such service in the pres- 
ence of a credible witness, or may have been by him acknowledged 
in writing, signed in the presence of the superintendent or other 
officer authorized by the superintendent. 

Section 14. Lepers trusting one another do so entirely at their 



412 THE PATH OF THE DESTROYER 

own risk, as they will not be assisted in collecting claims by the 
Board of Health or the superintendent. 

CULTIVATION OF LAND. 

Section 15. Lepers and kokuas may cultivate their residence 
lots and dispose of the crops so raised, without giving a share of the 
same to the Boarld of Health, or paying for the use of this land. 

Section 16. Persons desiring land outside of their residence lot 
for cultivation must make application for the same to the superinten- 
dent of the Settlement, stating the locality and area of the land de- 
sired. 

Section 17. No person shall be allowed more land than he or 
she can cultivate. Any person neglecting to plant or properly care 
for land assigned to such person, shall forfeit all right to such land 
and the crops growing thereon, and such land may be assigned to an- 
other person. 

Section 18. All land assigned for cultivation must be enclosed 
by a cattle-proof fence, for which the Board will furnish material, 
without charge, and the Board will not be responsible for any damage 
to crops done by cattle. 

Section 19. No land for cultivation shall be transferred to an- 
other without the consent of the superintendent. 

Section 20. Land in Waikolu Valley assigned for taro planting 
shall be held and used under the following condition: (a) the entire 
crop raised shall be delivered to the Board, which will pay for three- 
fourths of the same at the current market price; (b) neglect to prop- 
erly cultivate, or failure to deliver the crop to the Board when ripe 
shall be sufficient cause for the forfeiture of all right to the payment 
above provided for; (c) no person cultivating taro at Waikolu shall 
be allowed to remain away from the Settlement over night. 

KOKUAS MUST HAVE PERMITS. 

Section 21. No person who is not a leper shall be allowed to 
live at the Leper Settlement as a kokua for lepers, without having first 
obtained written permission to do so from the Board of Health. 

KOKUAS MUST DO THEIR DUTIES. 

Section 22. Every kokua must minister to the wants and the 
necessities of the leper for whom he or she has been permitted to 
live at the Settlement. 

Any kokua who deserts or neglects the leper for whom he or she 



THE PATH OF THE DESTROYER 413 

obtained the permit shall forfeit such permit and shall oe expelled 
from the Settlement. 

Section 23. All permits of kokuas terminate with the death of 
the party or parties for whom they have been serving as kokuas, and 
such kokuas must leave the Settlement on or before the expiration of 
two weeks after the death of such party or parties; provided, the 
physician at the Settlement shall, on examination, pronounce such 
kokuas to be free from all suspicion of leprosy. 

Section 24. Kokuas must work for the Board when called upon 
by the superintendent, and for such services they shall be paid fair 
wages; provided, however, they shall not be called upon by the super- 
intendent when the condition of the party or parties for whom they 
are kokuas shall demand their constant presence and attendance, for 
which the certificate of the physician shall constitute a sufficient proof. 

Section 25. Kokuas may build houses for the party or parties for 
whom they are kokuas, under the asme condition as lepers. 

KOKUAS NOT ENTITLED TO RATIONS. 

Section 26. Kokuas shall not be entitled to rations of any kind. 
They shall not be allowed to own horses or dogs at the Settlement. 

Food rations, however, may be issued to them in lieu of services 
rendered to the Board, on the recommendation of the superintendent. 

Section 27. Kokuas shall not leave the Settlement without the 
written consent of the superintendent, and then only on important 
business concerning the Board of Health. 

KOKUAS BREAKING RULES TO BE EXPELLED. 

Section 28. Any kokuas duly convicted for violating the laws 
or for disregarding the rules and regulations of the Board of Health, 
shall forfeit his or her permit and must leave the Settlement within 
one week after conviction, or suffer the penalty provided by law. 

HOG RAISING. 

Section 29. Lepers and kokuas are permitted to raise hogs at 
their own expense, and in such manner that they do not become a 
nuisance to the Settlement and injury to others, to their houses and 
plantings. 

They are required to raise their hogs in yards or pens built by 
themselves, and at their own expense, and are not allowed to let them 
run at large. 

Hogs found at large may be confiscated and sold at public auc- 



414 THE PATH OF THE DESTROYER 

tion to the highest bidder, and one-half of the net proceeds shall be 
paid over to the Board of Health and the other half to the owner 
of the hog or hogs. Hogs for which no bid is received shall be killed 
by some officer appointed by the superintendent of the Leper Settle- 
ment. 

FIRE ARMS. 

Section 30. Lepers in charge of and supported by the Board 
of Health of the Territorial government in the Leper Settlement at 
Molokai, shall not be allowed the use of spirituous liquors, except 
as the same may be required for medical purposes, or shall not be 
allowed the use of fire arms. 

RULES AND REGULATIONS FOR THE BAY VIEW 
HOME FOR LEPERS AT KALAUPAPA. 

This Home is for the benefit of lepers of both sexes who have 
become too helpless to provide and cook for themselves, and will be 
conducted as a boarding-house, with lodging rooms for those who 
may not be able to walk from outside dwellings. 

Rule 1. No male leper under the age of eighteen, nor female 
under the age of sixteen will be allowed to reside at the Home, unless 
the parent of the same is an inmate. 

Rule 2. No food will be supplied to an inmate of the Home, 
but meals will be furnished three times each day at the dining-room, 
or at the sleeping room, if the condition of the inmate prevents his 
appearance in the dining-room. Meals will be served at 8 a.m., 12 
p.m. and 5 p.m. 

Rule 3. Persons wishing to board, or board and lodge at the 
Home, must make application to the Superintendent of the Settle- 
ment or his assistant, each of whom has authority to grant or refuse 
such application if he considers the applicant is not a fit subject for 
the Home. 

Rule 4. The usual clothes ration bills will be issued to the 
inmates, who will furnish their rooms in the same manner as those 
living outside the Home. 

Rule 5. The inmates will be free to leave or return to the 
Home at any time between 6 a.m. and 9 p.m., at which hour inmates 
are required to retire for the night. 

Rule 6. The inmates must conform with all rules and regu- 
lations of the Board of Health, and live in an orderly and peaceable 
manner, and each inmate must take care of his or her room if able 
to do so. 



THE PATH OF THE DESTROY ER 415 

Rule 7. Persons living outside the Home will be allowed to 
visit their friends at the Home between the hours of 9 a.m. and 
5 p.m., but will not be allowed to make it a daily loafing place. 

RULES AND REGULATIONS FOR THE BALDWIN 

HOME. 

"Baldwin Home" is a retreat at all times open to leprous boys 
and men, who, through progress of the disease, or other cause, have 
become helpless or partly so. This Home is not, however, to use 
as a convenient retreat, free boarding or lodging house for those who 
wish to shirk all labor. 

The following regulations are issued by the Board of Health 
for the guidance of those conducting the Home, and for the inmates 
thereof, who are required at all times to give respectful obedience 
to the manager of the Home and his assistants. 

1. All boys arriving at the Settlement under the age of eighteen, 
unless in the care of their own parents, responsible guardians or near 
relatives, competent to take charge of them, will enter the Home, 
and there remain during good conduct; provided that after reach- 
ing the age of eighteen it is their option to leave, if able to take care 
of themselves, upon obtaining the consent of the superintendent of 
the Settlement. While there is sufficient accommodation in the 
Home, the superintendent of the Settlement may permit any male 
leper to be admitted, if satisfied that the applicant will not be an 
injury to the Home. 

2. Inmates will be supplied with suitable clothing, food, care 
and medical attendance, and when able, will be expected to perform 
freely such work and labor about the establishment as the manager 
shall require of them. 

3. Inmates must not absent themselves from the Home with- 
out first obtaining permission from the manager or his assistant, and 
must be punctual in their return. Their conduct must be quiet and 
orderly, then and at all times. 

4. Admission of visitors and of others from outside the Home, 
will be regulated by the manager. 

5. Violation or disregard of the rules and regulations will be 
followed by suitable punishment, after due investigation by the super- 
intendent of the Settlement. 

6. Persistent disobedience, insubordination or disorderly conduct 
will debar an inmate from the privileges of and cause his expulsion 
from the Home. 

7. The manager shall make report to the Board of Health, from 



416 THE PATH OF THE DESTROYER 

time to time in writing, regarding any conditions that may arise 
calculated to affect the interests of the Home. 

8. No horse, nor cart, nor any tool, nor any property whatsoever, 
belonging to the Home, may be loaned or taken for any outside 
purpose without an order from the superintendent of the Settlement. 

9. The superintendent or acting superintendent of the Settle- 
ment will make an inspection of the Home once each week. 

RULES AND REGULATIONS FOR THE BISHOP HOME. 

The "Bishop Home" has been established for girls of all ages 
and unprotected females, married or unmarried, who, having con- 
tracted leprosy, have become helpless and have no relatives at the 
Settlement able properly to care for them. 

1. The inmates of this Home will be supplied with all things 
necessary for their comfort and will be carefully cared for by the 
Sisters. They are required to observe the rules and regulations of 
the Home; to be obedient and respectful to the Sisters in charge 
and to perform light work suitable to their strength. 

2. For substantial services, if they are capable and willing to 
perform them, they may be remunerated by the matron in charge 
as agreed upon between her and the superintendent of the Settlement. 

3. It is compulsory for girls arriving at the Settlement under 
the age of sixteen years, to enter the Home, unless they have parents, 
near relatives or guardians at the Settlement who are competent to, 
and who will take proper care of them. 

They shall remain at the Home until they reach the age of six- 
teen years, after which they may, if they prefer, leave the same upon 
making their wishes properly known to the matron in charge and 
to the superintendent of the Settlement. 

4. The inmates are not allowed to leave the Home at any time 
without previously obtaining the consent of the matron; and they 
must return according to the rules governing the Home. 

5. Visitors to the inmates will be allowed admission to the Home 
after having first received permission from the matron. 

6. Violation of the rules or regulations will be followed by 
suitable punishment, administered by the superintendent of the Set- 
tlement after due investigation. 

7. Any inmate may be dismissed from the Home for disorderly 
conduct. 

8. Inmates shall not be received at the Home nor dismissed from 
it without the approval of the superintendent of the Settlement. 



THE PATH OF THE DESTROY ER 417 

9. The superintendent or acting superintendent of the Settle- 
ment will make an inspection of the Home once each week. 

RULES AND REGULATIONS FOR KALIHI STATION. 

1. Segregation. — No inmate of the hospital shall be allowed 
outside of the enclosure surrounding the hospital grounds, except by 
permission of the executive officer of the Board. 

2. The keeper and patients are under the immediate direction 
and control of the medical superintendent. 

Duties of the medical superintendent are to see that the rules 
of the hospital and experimental station are carried out ; to make 
requisition for all medical supplies and material, and to approve bills 
for the same ; to have the management and control of the laboratory, 
including all bacteriological and microscopical investigations neces- 
sary for diagnosis and treatment, and to conduct the medical and 
surgical treatment of the inmates. 

4. The duties of the keeper are to see that the discipline and 
rules of the institution are carried out, and that the routine pre- 
scribed by the committee and medical superintendent is followed. 

5. No visitors shall be allowed entrance, except with the per 
mission of the executive officer of the Board. 

6. The inmates are expected to submit faithfully and cheerfully 
to the rules and regulations of the experimental station as a con- 
dition of their enjoyment of its benefits. 

REGULATIONS FOR VISITORS TO THE LEPER 
SETTLEMENT AT MOLOKAI. 

The superintendent of the Leper Settlement at Molokai is here- 
by directed to have set apart a parcel of land of about half an acre 
in area near the landing at Kalaupapa, the same to be enclosed with 
a double fence, together with entrance thereto, so that persons may 
reach said enclosure and remain therein without being able to come 
in personal contact with any inmate of the Settlement. In the en- 
closure shall be provided suitable buildings for the convenience of 
those who shall have occasion to use them. This enclosure shall be 
known as the visitors' compound, and no leper shall be allowed 
within it. 

2. The superintendent of the Settlement is hereby directed to 
admit no one to the Settlement without a permit authorized by the 
Board of Health, and to keep an accurate record of all who shall 
enter. 



418 THE PATH OF THE DESTROY ER 

3. Officers of the Board of Health, or of the Federal or Terri- 
torial government whose duties shall require their presence at the 
Settlement, may obtain permits from the executive officer of the 
Board. 

4. Lepers regularly committed by the Board of Health shall be 
accompanied by a complete list, giving name, sex, age and nationality 
of each person. 

5. Persons having friends or relatives among the inmates of 
the Settlement, or anyone having business to transact with any in- 
mate, may obtain from the executive officer of the Board a permit 
to visit the Settlement (upon showing good cause), which permit 
shall allow the holder to go upon any regular trip of the steamer 
to Kalaupapa, at his own expense, but he shall only be allowed to 
remain on shore during the hours of daylight that the steamer re- 
mains in port, and while on shore shall be obliged to remain in the 
visitors' compound. Such permits shall be good only for the trip 
designated. 

6. No other persons shall be allowed to visit the Settlement, 
except as permission is authorized by a vote of the Board of Health. 

7. The executive officer of the Board shall keep a correct record 
of all permits issued. 

REGULATIONS RESCINDED. 

All regulations of the Board of Health not included among the 
foregoing are hereby rescinded. 

PENALTY. 

Every person who shall violate any regulation of the Board 
of Health, after the same shall have been published, shall be fined 
not exceeding one hundred dollars. 

DOGS. 

No leper or person residing in the Leper Settlement at Molo- 
kai shall have the right to keep more than one dog. 

It shall be the duty of the superintendent to see that this sec- 
tion is enforced. 

This section, however, shall not go into effect until the first of 
July, 1903. 



THE PATH OF THE DESTROYER 419 

RULES AND REGULATIONS FOR LEPERS AND 
KOKUAS LIVING AT THE SETTLE- 
MENT ON MOLOKAI. 



INTOXICATING BEVERAGES. 

No person residing in the Leper Settlement, Island of Molokai, 
shall have the right to manufacture, brew, or in any way make an 
intoxicating beverage; or to have in his possession, custody or con- 
trol, or to sell or to dispose of in any way, what is commonly known 
as "Swipes." 



AN ACT 



PROVIDING FOR THE CARE AND MEDICAL 

TREATMENT OF PERSONS AFFLICTED WITH 

LEPROSY. 

Be It Enacted by the Legislature of the Territory of Hawaii: 

Section 1. Hospital. There shall be established at and on 
such place on the Island of Oahu, Territory of Hawaii, as the gover- 
nor shall direct, a hospital for the care of persons afflicted with 
leprosy, there to receive such treatment as shall be provided or 
approved by the Board of Health. 

Section 2. Treatment at Hospital. At such hospital every 
reasonable effort shall be made to effect a cure of the patients, and 
such patients shall be cared for as well as circumstances will permit 
and given such liberties as may be deemed compatible with public 
safety. They shall be treated by such licensed physician or physi- 
cians as the Board shall designate, but if any patient so prefers, he 
may be treated at his own expense by a licensed physician of his 
own selection under such conditions as the Board may prescribe. 
Any person may, at any time, secure free of charge at such hospital, 
an examination for the purpose of determining whether or not he 
is a leper, and in case he is found not to be a leper, the Board shall, 
upon request, furnish him with a certificate setting forth such fact, 
the date of examination, and the name or names of the physicians 
making such examination. 

Section 3. Notification. Every person who knows, or has rea- 
son to believe that he, or any other person not already under the 
care or control of the Board of Health, is a leper, shall forthwith 
report to the Board or its authorized agent, that fact, and such 
other information relating thereto as he may have and the Board 
may require. 

Section 4. Examination. Any person so reported, or otherwise 
believed to be a leper, may be examined at any time and place and 
by any physician or physicians that may be agreed upon by him and 
the Board or its agents. 

The Board or its agents may, however, instead request such 
person to appear at a designated time and place not less than five 
days thereafter, and then and there to submit to an examination by 



422 THE PATH OF THE DESTROY ER 

a designated physician for the purpose of ascertaining whether such 
person is a leper. 

If, however, such person prefers such examination to be made 
by more than one physician, he may so notify the Board or its agent 
at any time so designated and may at the same time, or within such 
further time as the Board or its agent may allow, designate to the 
Board or its agent one licensed physician, in which case the Board 
or its agent shall within five days thereafter designate to such physi- 
cian a second licensed physician, and at the same time so notify 
such person and such second physician, and the two physicians so 
designated shall within five days thereafter designate to the Board 
or its agent a third licensed physician, and if they fail to do so, such 
third physician shall be designated by the Circuit. Judge of the cir- 
cuit in which the examination is to be held, and in the case of 
the first circuit by the First Circuit Judge; and in case such person 
shall fail to designate a physician within the time allowed, all three 
physicians shall be designated by such judge; notice of any such 
designation or designations by a judge shall be given forthwith to 
such person, and to the Board or its agent; when the three physi- 
cians have been so designated, such examination shall be made by 
them or a majority of them at a convenient time and place desig- 
nated by the Board or its agent, reasonable notice of which shall 
have been given by the Board or its agent to such person and such 
physicians. 

The physician or physicians who make the examination shall re- 
port to the Board or its agent whether in his or their opinion such 
person is a leper. 

If such person is under the age of sixteen years, his parent or 
guardian, if any, may exercise such preference and thereafter rep- 
resent such person as far as may be for the purpose of this section. 

If upon such examination such person is found not to be a leper, 
the Board shall furnish him, or her, upon request, a certificate setting 
forth such fact, the date of examination, and the name or names of 
the physician or physicians making the examination. 

Section 5. Transfer to Hospital. If upon such examination 
such person is found by such physician or physicians or a majority 
of them to be a leper, he shall be transferred by the Board or its agent 
to such hospital. If he shall refuse or fail to appear and submit to 
any such examination at the time and place designated or agreed, 
he may be arrested and taken to such hospital upon a warrant issued 
by any circuit judge or district magistrate upon a sworn complaint 
setting forth the necessary facts, and shall there be examined as near 



THE PATH OF THE DESTROYER 423 

as may be as provided in Section 4 of this Act. All lepers at such 
hospital shall remain in the custody of the Board, and its agent, un- 
til discharged or removed by its direction or permission. 

Section 6. Removal to Settlement. Any leper may be removed 
from such hospital or any other place to the Leper Settlement at 
any time with his consent; but no leper shall be so removed until 
he has been at such hospital for at least six months, unless, in the 
opinion of at least three licensed physicians he cannot be materially 
benefited by further treatment there, provided, that any leper whose 
custody it has been necessary to obtain by arrest or who is unwilling 
to receive such treatment or to submit to such rules and regulations 
as the Board may approve or prescribe, may be so removed at any 
time. When so removed he shall remain in the custody or control of 
the Board until lawfully discharged. 

Section 7. Discharge. Any person detained as a leper, whether 
at the hospital or at the Settlement, shall be released whenever the 
Board shall be satisfied in any way that he is not a leper. Upon the 
request of any such person at any time not less than one year after 
any previous examination, he shall be examined by three licensed 
physicians to be chosen in the manner provided in Section 4 of this 
Act. A decision by a majority of the examining physicians that he 
is not a leper shall entitle him to a discharge. 

Section 8. Expense Rules. The Board shall bear all expenses 
of travel and other necessary expenses incurred under this Act, and 
may prescribe all rules, regulations, and forms, and perform all acts 
necessary and proper for carrying out its provisions. 

Section 9. Penalty. Any physician, or police, or other officer 
who shall violate the provisions of the third section of this Act shall 
be liable to a penalty of not more than One Hundred Dollars, and 
in addition thereto forfeiture of his license to practice, or to re- 
moval from office, as the case may be. 

Section 10. Repeal. Sections 1122 and 1122A of the Revised 
Laws, and Act 122 of the Laws of 1907 are hereby repealed. 

Section 11. The sum of Forty Thousand Dollars is hereby ap- 
propriated, out of moneys in the treasury, received from the general 
revenues, for a hospital to be erected under this Act. 

Section 12. This Act shall take effect upon its approval. 

Approved this 14th day of April, A. D. 1909. 

WALTER F. FREAR, 

Governor of the Territory of Hawaii. 



424 THE PATH OF THE DESTROYER 

Act of 1870, Chapter XVI, Relating to Divorce. — 

Section 1. Divorces from the bond of matrimony shall be 
granted for the cause hereinafter set forth, and no other: 

First — * * * "And when it is shown to the satisfaction of the 
court that either party has contracted the disease known as Chinese 
Leprosy , and is incapable of cure." 



INDEX 



A 

Abigail 79, 392 

Aborted or Sterile cases 

112, 113, 145, 157, 253, 254, 321 

Abusive stories, Fr. Daraien 241 

Adductor pollicis muscle 113 

Aerogenes capsulatus bacillus 188 

Aesculus turbinata 246 

Africa, South 62 

Ahia, Case of 30 

Aitken, Dr. William 382, 384 

Akana, Chinese 110 

Aku 120 

Akule 120 

Albert Montiton, Fr 249 

Alcohol 188 

Two Foreign Women Addicted.... 173 

Alexander, Prof. W. D 11, 27 

Alimentary Canal 124 

Alimentation ;...., 379 

Alkaline Saliva 123 

Alkalinization of Gastric Juice 11, 192 

Alkalinize the Saliva 121 

Ally of Ignorance 172 

Alopecia 192, 244, 250 

Anaerobic, Facultative 177 

Anaesthetic or Neural Leprosy 

24, 82, 91, 104, 111, 113, 138, 157, 188 

206, 254, 321, 323, 334 

Anderson, Soldier, Killed 75 

Animals Not Affected 168 

Anthony, Convent of St 170 

Apostle of Fatalism 128 

Archambaux, Fr. Gregoire 11, 251 

Archangel Gabriel 263 

Archdeacon Mason 206 

Armstrong, Rev. R 41 

President W. N 85, 180, 182 

Arning, Dr. Ed 55, 110, 320, 341, 379 

Artificial Leprosy 190 

Arum Esculentum 39, 125 

Triphyllum 39 

Asiatic-Hawaiian 134, 179, 184 

Asthma 252 

Atreya, Dr 45, 158 

Audumbara 46 

Austin, Judge J. J 153 

Autobiography, Fr. Damien 211 

A. Hutchison 204 

Awa, Drinking, Effects of 115 

Anaesthesia 115 

Intoxication 115 

Medicinal Uses of 115 



Spreader of Leprosy 116, 117 

Axiom, Significant 169 

Azores, Islands of 60, 322 

B 

Bacillus Leprae 59, 82, 98, 99, 101, 107, 

108, 109, 110, 111, 112, 113, 116, 118, 

120, 121, 122, 124, 129, 131, 132, 134, 

142, 144, 145, 147, 155, 157, 158, 162, 

163, 164, 168, 169, 173, 175, 177, 178, 

183, 187, 188, 191, 192, 321, 322, 326, 
327, 334, 409. 

Hansen's B. Leprae 161 

B. of Leprosy, Leprous Bacillus, 
leper bacillus have similar 
meaning. 

In the saliva....H5, 116, 120, 124 

Selective sites 162, 321 

Size of 161 

Bacillaemia 163 

Bacilligenic 124 

Bacillus or Spirochaeta of Syphilis.... 108 

Bacterial Infection 157 

Baelz, Dr 386 

Baldwin, H. P 291, 350 

Home 281, 291, 356 

Banana 39 

Bancoora 45 

Bed Bugs 101 

Beef Supply 214, 279, 317 

Beerbhoom 45 

Bending of the Oak, The 247 

Benson, Dr 384 

Beratz, Dr 251 

Bergen, Norway 159, 160 

Bible, Leprosy cases of 46 

Birth Rate, Lepers' 106 

Bishop, Rev. A 41 

Chas. R 286, 289, 328 

Sereno 30 

Bishop Gulstan 248 

Herman 170, 244 

Maigret 229 

Bismuth Salicylate 186 

Blood, B. Leprae Absent 25, 162, 322 

Present 163 

Bloodless Revolution 264 

Blount, Comsr. U. S 72 

Board of Health, First 32 

Personnel 69 

Boeck, Dr. C 160, 174, 388 

Bone, T. B. of 124 

Brazil 60 



II 



INDEX 



Breath of the Leper 103, 107, 108 

Breslau, Germany 158 

Brickwood, Mr 30 

Louisa 30 

Brinckerhoff, Dr. W 58, 189, 198 

British Indian Leprosy Commas 169 

Brother Joseph Dutton 236, 283, 291 

Bubonic Plague 27, 128, 200 

Bulgarian Bacillus 186 

Burgermann, Fr. Andre 11, 254 



Cadaveric Bacilli 110, 120, 177 

Caecum 109 

Cagnina, Dr 139 

Calabash 125 

Calcium Sulphide 380 

Calopus, or Stegomyia Fasciata 95 

Canton, China 28 

Cashew 186 

Caries of Bone 56 

Carriers of Leprosy 24, 111, 113, 145 

Caste in Indian 62 

Catarrhs 39 

Catholic Church, no Hawaiian priest 240 

Caucasian-Hawaiian 133, 134, 135, 179 

Celebrated Case, A (Fr. Damien).... 151 

Keanu 151 

Censure of the Doctors 49 

Census, Eight Periods 165 

First American 21, 100 

Cervical Canal 112 

Chalice, Gift of to Fr. Wendelin.... 258 

Change of Form 82, 187 

Chapin, Dr. Alonzo 36 

Chapman, Rev 249 

Charaka Sanpita 45 

Charcot, Dr. Jean 190 

Charlie, Japanese 152 

Chaulmoogra Oil 187 

Children of Lepers, Draw Rations.. 78 
Early Development Leprosy in 

163, 336, 393 

Two only out of twenty-six be- 
come lepers 393 

Many born, few survive 106, 373 

Chinese in Hawaii, First Coolies.... 27 

Sickness or Ma'i Pake 27, 28, 280 

Cholera 27, 128, 199, 200 

Chronological Table 199, 200 

Church, Bethel Street 361 

Fort Street 290 

St. Philomena 239 

Siloam 239 

St. Francis 256 

Puna Mission 224 



Clarke, Rev. E. W 41, 43 

Cleghorn, A. S 263, 312 

Cleveland, President 72 

Clothing for Lepers 218 

Coan, Miss Harriet 11 

Rev. Titus 40, 43 

Coffins, in Burial Ground 237 

At Hospital Gate 300 

Colon or Large Intestine 109 

Commission of Physicians 76, 409, 420 

Condemned Outcast 204 

Conjugal Infection 103, 177 

Non-infection 104, 177 

Relation 103 

Conjunctivitis from Awa 115 

Conrardy, Fr. L 248, 261 

Contact, Intimate....l02, 170, 175, 386, 397 

Contagion 164, 177, 254 

Contagious, to Careless 24, 164 

Non 173, 382, 389, 395 

Not to Careful 24, 164, 172 

Barbadoes 383 

Benaveo 383 

Crete 383 

Jamaica 382 

Mauritius 383 

Mytilene 383 

Nagpore 383 

New Brunswick 383 

Norway 382, 388 

South Carolina 384 

Convent of St. Anthony 170, 171 

Cook, Capt. James 2, 41 

Correspondence Board of Health 

with Dr. Arning 341 

Counterfeit of Poi 125 

Cousin Brother, etc 154 

Cradle of the World 46 

Crater of Kauhako 66, 67, 308, 359, 360 

Cross Roads of Pacific 60 

Crown of Thorns 238 

Crustacea 39 

Culex Pipiens 95 

Cunningham and Lewis 44 

Cutaneous Diseases 41 



Damien, Fr., arrival at Kalawao.... 229 

Arrival at Honolulu 229 

His death, April 15, 1889 249 

Careless in contact 236 

Orphanages 76 

Personal appearance 229 

Temperament 231 

Progress of his leprosy 244 

Episodes of his . life 236, 243 



^ 



INDEX 



III 



Fearless, zealous worker 238 

His assistant priests, Andre, Al- 
bert, Conrardy, Gregory, Wen- 

delin 249, 251, 254, 261 

Danielssen, Dr. C...138, 160, 174, 382, 388 

Dayton, David, Dep. Marshal 166 

Death Rate, General 22, 190 

Leper Settlement 238, 316 

Deccan, India 45 

Decimation by Alcohol 189 

Dengue 95 

De Novo 25, 254 

Dermal Surface 24, 94, 138, 191 

Dicta of Wisdom, etc 172 

Diet of Lepers 213 

Direct Policy 204 

Disinfectants, Intestinal 186 

Doctors, Contacts, etc 169, 172, 175, 397 

Donors, Partial and Impartial 291 

Dowsett, James 1 30 

Dual or Mixed Leprosy 24, 91 

Duration of Leprosy 234, 391 

Dutton, Brother Joseph 283 

Lieut. Ira B 283 

Dysentery 109, 317, 324 



Felice, Ship 28 

Female More Immune 179, 380 

Excess of Chinese-Hawaiians 179 

Fertility 106 

Fevers 39 

Finger Nails Carry Bacilli 131 

Fire-arms 82, 414 

Fish, Raw 120, 131 

Salt 121 

Fission or Segmentation 162 

Fitch, Dr. G. L 54, 55, 313, 316, 382 

Fleas 101 

Flies 98 

Foreign Lepers, Number of June 

30, 1912 60 

Fosters Fish Bacillus 120 

Formula OoHie 186 

Forty-eight Years a Leper 203 

Four Per Cent of Lepers 158 

Fox, Dr. Tilbury 167 

Franciscan Sisterhood 170, 171 

Frankel's Pneumococcus 122 

Fresh Foci of Infection 140, 156 

Friedlander's Bacillus 122 

Fuchsin 161 

Fulminations 53 



Easter Morn 249 

Early Cases of Leprosy 29, 30 

Development 163, 336, 393 

Ecclesiastical Weapons 53 

Ectropion 115, 145, 335 

Eight Census Periods 165 

Eleu, Steam-tug 80 

Emerson, Rev. J. S 41, 43, 44, 292 

Dr. N. B 198, 205, 265 

Mrs. Dr 347 

Mrs. U 95, 292 

Entero-toxism 186 

Epiglottis 109 

Epilogue 193 

Ethical Phases of Leprosy 58 

Eucalyptus Oil 186 

European Leprosy 51 

Evans, T., Superintendent 205 

Excerpts 83 

Exfoliated Mucosae 109 

Experiment of Segregation 85 

Expert Kahuna 206 

Extinction of Leprosy 82, 169 



Facultative Anaerobic 177 

Faeces, Bacilli Leprae in 109, 113 

Family Leprosy same form in all 187, 380 
Fell Destroyer ' 256 



Gastric Juice 121, 122, 191, 192 

Ghost of Immorality 235 

Gibson, Walter M 

47, 48, 49, 80, 85, 170, 228 

Glandular T. B 109, 124 

Glossary 194 

Goldsmith, Dr 260 

Goodhue, Dr. W. J 198 

Goto, Dr. Masanao 244, 246 

Gram's Stain 161 

Granular Type of Bacilli 161 

Graves of Lepers 109, 237, 243, 339 

Green, Rev. J 40, 41, 43 

Grief and Anguish 247 

Guaiacol Carbonate 380 

Gulick, Mr 44 

Gumma 56 

Gynocardia Odorata, from the 
seeds of the tree Chaulmoogra 
Oil is obtained 186 

H 

Habeas Corpus 72 

Hala or Puhala Tree 211, 233 

Halawa Valley 209, 214, 272 

Hanaloa, Rev. J ...240, 292 

Hansen, Dr. G. A 24, 159, 387 

Hansen's B. Leprae 161 



IV 



INDEX 



Haole Doctor 128 

Hardy, B. F 32 

Harbinger of Hope, Our 129a 

Hassinger, John 166 

Haustorium 98 

Hawaiian Doctor 129 

Hospitality 180, 183, 253 

Language 370 

Majority Immune to Leprosy 165, 375 

Social Habits 180 

Heredity 178, 396 

Hereditary 178, 396 

Hereditary Predisposition 396 

Herman, Bishop of Olba 170, 244, 261 

Heuck, T. C 63, 65 

Hillebrand, Dr 30, 63, 199 

Hilo, Island of Hawaii 253 

Hitchcock, Marshal E. G 72, 73 

Hoffman, Dr. Ed 63, 83 

Homeless Leper and Orphan 242 

Homogeneous 161 

Honolulu Declared a City 32 

A Leper Case of 30 

Hopkins, Chas. G 63 

Hospital, Kakaako 31, 65, 246, 313 

Kalawao 302 303, 363 

Kalihikai , 63, 65 

Lungegaarde 139 

Queen's 33 

St. Bartholomew's 399 

St. George's, Bergen 382 

House Disease, Leprosy 172 

Hawaiian, one room 53 

Norway, one room 53 

Grass, spreader of disease 42 

Hutchison, Case of Ambrose 204, 206 

Deputy Superintendent 203 

Dr. W. F 83 

Hyde, Rev. C. M 395 



I 

Ileum, Ulcers of 109 

Iliopi, Village of 251 

Immune 158, 165, 167, 375 

Immunity, Various Forms 149, 157, 158 

Incubation of Leprosy 25, 86 

Incubative Period of Disease 158 

India. Leprosy in 45 

Indies, West 60 

Indigenous 27 

Individual to Individual 235, 254 

Infected Dust 175 

Infection, Fresh Foci 140, 156 

Infective Neuritis..56, 59, 82, 113, 188, 253 

Inoculation, Accidental 396 

Experiments 138 



Positive . 138 

Cagnina, Dr 139 

Danielssen, Dr 138, 139 

Fitch, Dr 391, 398 

Mouritz, Dr., cases of 141 

A, B, C, D, E, F, G, H, I, 

J (m), O, P, Q, R, S, (f), 147 

Oliver, Dr 399 

Profeta, Dr. G 139 

Inoculable, not, Dr. Fitch himself.... 391 

Dr. Arning himself 391, 396 

Kauuku 391, 396 

Inspection of Fr. Damien 236 

Instinct of Location 188 

Intermingling of Lepers and Healthy 167 

Intestine, Large 109 

Intestinal T. B 124 

Intimate Contact....l02, 170, 175, 386, 397 

Introitus Vaginae 112 

Investigator, Leprosy 110 

Iphigenia, Ship 28 

Isomeric, equal parts, different 

chemical properties 186 

Itch, Scabies or Sarcoptes 132 

J 

Japanese Poi Eater, A 135 

Java, Leprosy in 49 

Jenner, Dr. Ed 95 

Johnson, Mr 44 

Judd, Chief Justice A. F 11, 153 

K 

Kadala Kushta 45 

Kahuna, Priest or Doctor 128, 129 

Kailua, Kona, Hawaii 71, 199 

Kakaako Hospital 65, 246, 313 

Kakanaka 46 

Kalakaua, King 35, 170, 273, 295 

Kalalau Valley 70, 72 

Kalama, Meyer 262 

Kalawao or Kalauwao 

- 65, 66, 238, 360, 362 

Family Hotel 237 

Kalaupapa 65, 66, 76, 81, 360, 362 

Kalihi or Kalihikai Hospital 63, 65 

Kamaainas at Kalaupapa 70, 71 

Kamaka, (w) 152 

Kamakau, W. P 63 

Kamehameha III, King 32 

Kamehameha IV, King 33 

Kamehameha V, King 33, 34 

Kamuli (w), Case of 30 

Kanohoahu, Deputy Sheriff 80 

Kapa, Native Cloth 43 

Kapiolani Home 76, 82 



INDEX 



Kapiolani, Queen 295, 298 

Karsdusa 46 

Kauhako, Crater of....66, 67, 308, 359, 360 

Kauka or Doctor 128 

Kaulukou, Attorney 153 

Kaumualii, Police Officer 80 

Kaunakakai, Molokai 285 

Kawaihae, Island of Hawaii 29 

Kava or Kava-kava 115 

Kealoha (kj, Armed Leper 71 

Keanu, Inoculated, Murderer 152 

Keawe Kaiana, Chief 28 

Keliikipi (k), Exhumation of 110 

Kilauea, Volcano of 36 

Steamship 229 

King Street Detention Station 31, 65 

Kissing, Danger ot in Leprosy 131 

Koch, Dr. Robert 58, 161 

Kohala, Island of Hawaii 232 

Kokoolau Tea 40 

Kokuas or Assistants or Nurses 70, 78 

Male and Female 140, 147 

Desire to Become Lepers, malin- 
gerers 140, 141 

Number 140, 374 

Remarks of Fr. Damien on 221 

Remarks of R. W. Meyer on....273, 278 

Kolera, Ma'i, Cholera 27, 199, 200 

Koloa, Kauai 30, 75 

Kona, Hawaii 71 

Konkan, India 45 

Koolau, Leper Outlaw 74 

Kudig, Javanese Leprosy 49 

Kukui Nut 39 

Kuleanas 71 

Kumaun, India 45 

Kushta or Leprosy, India 45 

L 

Lady Washington, Ship 41 

Lahaina, Island of Maui 95 

Landing, Kalaupapa 81, 205, 208 

Kalawao 307 

Waikolu , 298, 306 

Lantana, a shrub forming dense 

thickets ; a pest in Hawaii 209 

Lathrop, Dr. G. A 32 

Lauhala, Leaf of the Hala Tree..211, 233 
Laws, Rules and Regulations: 

Acquiring Land 406 

Care and Treatment of 420 

Baldwin Home 415 

Bay View Home 414 

Bishop Home 416 

Cultivation of Land 412 

Divorces 424 

Dogs 418 



Duties of Kokuas 404 

Duties of Police Officers 404 

Exemption, Personal Taxes 408 

Fire-arms 414 

Harboring a Leper 403 

Hog-raising 413 

Intoxicants 419 

Kalihikai Receiving Station 417 

Medical Examinations 409 

Penalty 403, 404, 405, 423 

Regulations, Kokuas 410 

Duties of 41u 

Lepers 410 

Visitors 417 

To Establish Hospitals 35, 420 

To Prevent Spread of Leprosy 33 

Transport of Lepers 405 

Trespassing 408 

Visitors Require Permits 417 

Wills 411 

Legislative Enactment 33, 35 

Lenalena, Piva (Yellow Fever).. ..27, 200 

Leonor Fousenol, Fr 170, 386 

Lepers From Other Countries 60, 322, 338 
"Lepers of Molokai," by Stoddard.... 262 
Lepers from U. S. A. not received.... 22 

Leper Settlement, description of 66, 359 

Leper War on Kauai 72 

Leper Carrier, Leprous Carrier, 
under Carrier of Leprosy. 

Leprologists 11, 158, 160, 174 

Leproma 154 

Lepraphobia 82 

Leprogen 155 

Leprosy, Three Forms 24, 91 

Contagious to Careless 164 

Non-contagious to Careful 24, 165 

In Hawaii 60, 165 

Incubative Period ' 25 

In India 45 

And Svphilis 54 

Of the Bible 46 

In Europe 51, 387 

Most Ancient Disease 45, 56 

Leprous Dysentery 109, 324 

Tuberculosis 108 

Letters re Dr. Arning and the 

Board of Health _■ 341 

Leviticus, Book of 46 

Lewis and Cunningham 45 

Libel Suit 54 

Lichen Ruber Planus 115 250 

Lieut. Ira B. Dutton ' 28S 

Lightning Shocks 252, 254 

Liliuokalani, Queen, Report of ' 295" 

Lingual Saliva 123 

Litmus Paper 223; 



VI 



INDEX 



Lochia, no Bacilli Leprae 162, 178 

Lohiau (k), Assault to Murder 80 

London College of Physicians 169, 174 

Lot, Prince 26, 32. 33 

Luna Nui, Head Overseer 226 

Lungegaarde Hospital 139 

Lutz, Dr Ill 

Lymphatics 162, 163 

M 

McCabe, Killed by Koolau 75 

McCully, Judge Lawrence 153 

McKibbin, Dr. Robert 11, 30 

McNamara, Dr 167 

Magnesium Salicylate 186 

Ma'i Pake or Chinese Sickness 27, 28, 280 

Ma'i Bubonica or Bubonic Plague 27, 128 

Mahiki, Police Officer 80 

Makanalua, Leper Settlement 66, 359 

Malaria 37 

Male Sex More Lepers 178, 367 

Malingerers, Kokuas 141 

Maltose 123 

Man Sole Host of the B. Leprae 168 

Mandala 46 

Mary, "Little" 208 

Mazatlan, Mexico 95 

Meares, Capt 28 

Melting Pot 291 

Menstrual Fluid, no B. Leprae.— 113, 162 

Merrill, Minister G. W 154 

Mesenteric Glands 163 

Meyer, R. W 262, 265 

Mixed or Dual Leprosy 24, 91 

Moanalua, Suburb west of Honolulu 366 

Molokai Leper Settlement 65 

Description of 66, 220, 275 

Morals of 223 

Momona (k), Assault on the Police 80 

Montiton, Fr. Albert 249 

Morons 106 

Morvan, Dr 190 

Mosquito Experiments 98 

From Leper's Nets 96 

Haustorium 98 

Salivary Glands 98 

Mother Superior Marianne.. ..170, 236, 286 

Mott-Smith, President E. A 193 

Mott-Smith, President J. 84 

Mountain Scenery at Leper Settle- 
ment 362 

Mouth Infection 124, 127, 169 

Mucosae, Exfoliated 109 

Of Intestines 109 

Mucous Surface 155 

Mucus 109 



Mullet 120 

Munster, Westphalia 254 

Murder of Dr. Jared Smith 75 

Murderer Keanu, Inoculated? 154 

Mysterious Spread of Leprosy 

Alleged 119 

N 

Na'ea, George, Case of 30 

Nanism 106 

Naomi (w), of Halawa 209 

Naphthol 186 

Nasal Discharge, Cadaveric 177 

Nasi, Septum Ulceration of 177 

Necrosis of Bone 56 

Neilson, Dr. Charles 198, 265 

Neisser, Dr. Albert 24, 158 

Nerve Stretching 113 

Net, Mosquito 96, 107 

Neural Leprosy 

24, 82, 91, 104, 111, 113, 138, 157, 188 

206, 254 

Neurectasia, Nerve Stretching 113 

Neuritis, Infective 56, 59, 82, 113, 188 

Neuman, Paul, Attorney General.... 153 

Newcomb, W 32 

Niihau, Island of 129 

Niho Palaoa (tooth of flour) 57 

Non-contagious to Careful 24, 165 

Norway 388 

Dr. Fitch 396 

Nodular Leprosy 

24, 82, 91, 104, 110, 124, 154, 175, 187 

229, 234, 252, 391 

Non-motile, B. Leprae 24, 160 

Nootka, Ship 28 

Norway 53, 58, 61, 138, 160, 174, 388 

Notice, Board of Health to Lepers.... 63 

Nurses, Contact of.102, 170, 175, 386, 397 

O 

Oahu Jail 154 

Olba, Herman, Bishop of 170, 244, 261 

Oliver, Dr. Richard 11, 398 

Ominous Evidence 177 

Ophthalmia 29 

Opposition to Fr. Damien 238 

To Law of Segregation 70, 166 

Oriental Leprosy 32 

Orphanage, Fr. Damien's 76 

Ostracism of the Leper 53 

P 

Pala, a Fern Root 39 

Palolo, Valley East of Honolulu 63 

Panama Canal 95 



INDEX 



VII 



Pancreatic Juice 192 

Pancreas 192 

Parker, Rev. B. W 41, 44 

Parotid Saliva 123 

Pathogenic 168 

Paumotu Islands 250 

Pediculi 132, 134 

Pelekunu, Molokai 232 

Penile Inoculation Not a Fact 183 

Peyer's Glands or Patches 109 

Philomena St. Church 239 

Piilani, Wife Outlaw Koolau 74 

Pika, Kauka (Dr. Fitch) 54 

Pityriasis Versicolor 115 

Pocket Sublingual 173 

Poi, Experiments With 129 

Factories 182 

B. Leprae in Calabash 129, 132 

Japanese Eater of 135 

Contaminated by Leper's Finger.... 127 
On Fingers and Nails Convey 

B. Leprae 131, 132 

Politics and Segregation 166, 167 

Population, 1810, A.D., of Oahu 29 

1823, A.D., of Group 29 

1900, A.D., of Group 21 

1910, A.D., of Group..23, 179 

Leper, of Group 165 

Postulate 169 

Pouzot, Fr. Charles 11, 253 

Predisposition to Leprosy 178, 376 

Doubtful 396 

Prevalence of Disease 164 

Of Leprosy 165, 167 

Amongst Foreigners 100 

Amongst Hawaiians 167, 375, 391 

Priests, Leper Contact 102, 103, 317 

Priest, Leper, Popular Hero 229 

Prolonged Contact 175 

Propagation (used in the sense of 

to spread, not reproduced) 172 

Protective Bacteria 187 

Protein 123 

Protest of Dr. Arning 327 

Provisional Government 74 

Psoriasis 250 

Psoriatic, Awa 115 

Ptyalin 123 

Public Morals 156 

Puhala or Hala Tree 211, 233 

Pulu, a Fern 39 

Punalua 155 

Physicians of Leprosarium 198 

Of Leper Settlement 198 



Q 

Queen Emma 271 

Queen's Hospital, Report of 32, 33 

Queen Kapiolani 295, 299 

Queen Liliuokalani 295, 309, 312 

Quiescence 175 

Quinine 380 

R 

Races, Not Eating With Leper 132 

Racial Amalgam, Our 176 

Rainfall, Leper Settlement 67 

Keanae Valley 251 

Ratio of Lepers, Hawaii 21 

India 21 

Rations, Children Born at Settle- 
ment 78 

Rat Leprosy 169 

Reinfection 118, 175 

Reminiscences, Personal 201 

Report of Dr. Ed Arning 320 

Fr. Damien 211 

Dr. G. Fitch 382 

Queen Liliuokalani 295 

Dr. A. Mouritz 357 

Dr. J. H. Stallard 313 

R. W. Meyer 265 

Resident Superintendent 204 

Responsible Official, A 203 

Rhodes, Godfrey 63 

Rice, Less Contamination 135 

Rishyajihva 46 

Rooke, Dr. T. C. B 32 

Room House, One 53 

Rowell, William E 11, 200 

Rules and Regulations, See Laws 403 

S 

Saliva 123 

Salt Fish, Chemical Factor 121 

Mechanical Factor 118, 120 

Salt 122 

Salt Salmon 120 

San Paulo, Brazil m 

Sarcoptes Hominis (Itch) 132 

Scavenger Animals 168 

Schiff, Dr. Moritz 190 

Schools, Examination of, Dr. Arning 331, 

Fr. Damien's 306 

Kamehameha 337 

Scourge of Hawaiian People 204 

Second to None 243 

Segregated Lepers, Number of 165, 184 

Segregation Law, in Practice 69 

Norway 337 

Unpopular " 70 166 



V11I 



INDEX 



biloam Church 239 

Simeon, deputy Sheriff 71 

Sisterhood, Franciscan 170, 171 

Sisters, Nursing ..170, 236 

Site ot Leper Settlement Well 

Chosen 312, 359 

Smith, Dr. Jared 75 

Smith, President E. A. Mott- 193 

Smith, President J. Mott- 84 

Smith, R. H 32 

Smith, President William 286 

Sodium Phenolsulphonate or Sul- 

phocarbolate 186 

Solitary Glands 109 

Spain 51, 251 

Spleen 56 

Spores - 160 

Sporadic (here and there) 120 

Sputum 109, 168, 175 

Squire, Dr. Balmano 386 

Stallard, Dr. J. H 313 

Stegomyia Fasciata or Calopus 95 

Status of Leprosy, June 30, 1915 184 

Steamer Service 208, 210, 214 

Stenosis (narrowing) of Larynx 109 

St. Bartholomew's Hospital 399 

St. George's, Bergen • 382 

Sterile B. Leprae 113 

Sterility in Lepers 106 

Stewart, Rev. C. S 29 

Stimulants, Gastro-intestinal..... 186 

Stoddard, Chas. Warren 262 

Stolz, Deputy Sheriff ....... 72 

Sumner, Superintendent 241 

Sunshine at Leper Settlement 360 

Superintendent R. W. Meyer 

1 82, 262, 264, 297 

Supinator Radii Longus Muscle 154 

Susceptibility 157 

Sweep of the Reaper 260 

Sweet Potato Pap 163 

Swift, Dr. S. B 11, 154, 198 

Syphilis, Hawaiians, Not in Excess.... 167 

And Leprosy 55, 165, 167 

Alleged Fourth Stage 54 

Not an Ancient Disease 56 

Syringomyelia 190 

Systemic Infection 175, 186 

Systematic Infection 175, 186 



Table, Statistical '. 

60, 103, 165, 166, 184, 369 

Tanner, Dr. Hawkes 386 

Tax, Window 52 

Tears of Leper, B. Leprae Vari- 
able 162 



Tell, W. H., Superintendent 205 

Temperature, Honolulu 36 

Kalawao ... 67, 362 

Terpene 186 

Thaddeus, Ship 29 

Thenar Muscles 253 

Thoracic Duct 163 

Thurston, Lorrin A 286 

Ti or Ki Leaves 211 

Toilets, B. Leprae in 109 

Toxins , 158 

Tracadie Lazaretto 386 

Tragedy at Kalaupapa 79 

Transplanting Flesh 154, 155 

Transport of Lepers 210 

Tremeloo, Village of 229 

Birthplace of Fr. Damien 229 

Trophoneurosis 113 

Trousseau, Dr. G 11, 86, 153, 205, 389 

Trypsin 192 

Tuberculosis, Leprous 108, 109 

Tuberculin, in Leprosy 109 

Turpentine, Oil of 186 

U 

Ulcer, Buccal Mucosae 177 

Leprous Intestinal 109, 334 

Tongue , 177 

Tubercular 109 

Ulnar Nerve 59 

Unique Experiment 155 

University, of Superstition 128 

Unsegregated Lepers 165 

Urine, no B. Leprae in 162, 322 

V 

Vaccination 93, 329 

Vaccinophobia 93 

Vagina, Generally Absence of B. 

Leprae 113 

Introitus 112 

Vaginal, Douche 113 

Secretions 113 

Venereal Diseases 41 

V^erde, Islands, Cape 60 

Visceral Deposits 56, 109 

Visitors to Leper Settlement....21, 22, 417 

Volatile Oils 186 

Volcano of Kilauea 36 

Mauna Loa 36 

Votes, Hawaiians Have Majority.... 167 

W 

Waialua, Oahu 95, 96 

Waihanau Valley 66, 215, 266 



INDEX 



IX 



Waikolu Valley __ 216, 266, 311 

Wailau Valley 232, 272 

Waileia Valley 311 

Wairaea, Hawaii 12 

Kauai 72 

War, Leper on Kauai..... 72 

Warwick, Schooner 166 

Washington Lady, Ship 41, 199 

Water Supply, Addition 286, 308 

Not Absolutely Necessary (R. W. 

Meyer) 279 

Ways and Means Unknown 

(spread) 169 

Wavson, Dr. J. T. Ill 

Wells, Surface 52 

Wendelin, Fr. 11, 254 



Whiting, Austin, Deputy Attorney 

General 153 

Whitney, Henry M., Literary Man.... 11 
Widemann, H. A., President Board 

Health 84 

Wilcox, Luther 11, 30 

Wilder, President S. G 84 

Wilson, C. B 295 

Wind at Leper Settlement 360 

Wyllie, R. C, Prime Minister or 

Kuhina Nui 40 

Y 

Yellow Fever (piva lenalena in 

Hawaiian) 21, 95, 200 



